Jennifer J. Peacock, DNP, APRN, NNP-BC

Primary specialty

Neonatal Clinical Nurse SpecialistTaxonomy code 364SN0000X

License

289188-4405 Issued in UT

Practice address

2818 W 12875 S
Riverton, UT 84065-6837

Phone

(801) 232-6595

NPI assigned

Nov 22, 2015

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Sandy, UT
  • NPI 1942325154
  Medicare reassignment NPD
• Ihc Health Services Inc

  • Family Medicine Physician
  • Brigham City, UT
  • NPI 1790169654
  NPD
• Ihc Health Services, Inc.

  • Psychiatry Physician
  • St George, UT
  • NPI 1023843844
  NPD
• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Orem, UT
  • NPI 1588601124
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1448150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632873600000",
    "number": "1336513704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N MARIO CAPECCHI DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841131103",
            "telephone_number": "801-662-4100",
            "fax_number": "801-662-4166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2818 W 12875 S",
            "city": "RIVERTON",
            "state": "UT",
            "postal_code": "840656837",
            "telephone_number": "801-232-6595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEACOCK",
        "first_name": "JENNIFER",
        "middle_name": "J.",
        "credential": "DNP, APRN, NNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-22",
        "last_updated": "2021-09-29",
        "certification_date": "2021-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SN0000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Neonatal",
            "state": "UT",
            "license": "289188-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "collin.cowley@direct.imail.org",
            "affiliation": "N",
            "address_1": "2818 W 12875 S",
            "city": "Riverton",
            "state": "UT",
            "country_code": "US",
            "postal_code": "840656837",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Richard McCurry Patten, M.D.
• Jocelyn Patterson, CERTIFIED CASE MNGR
• Paula Lynn Paulson, INTERN
• Amanda L Pay, AUD
• PDC Riverton LLC
• Haley H Pedersen, FNP-C
• Pediatric Inpatient Services Riverton
• Kenna Renee Peters, PT
• Rylee Petersen
• Peterson Foodtown Inc

• Clinical Nurse Specialist in Riverton, UT
• Providers in Riverton, UT by specialty
• Clinical Nurse Specialist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.