Marianne Lynn Ravert Peacock, DPM

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

SC006134 Issued in PA

Practice address

2800 W Township Line Rd
Havertown, PA 19083-5215

Phone

(610) 449-3344

Fax

(610) 449-1325

NPI assigned

Jun 25, 2009

Last updated

Apr 22, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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

• Academy Podiatry Associates, P.C.

  • Foot & Ankle Surgery Podiatrist
  • Stratford, NJ
  • NPI 1841219003
  NPD (past)

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

{
    "created_epoch": "1245888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398124800000",
    "number": "1356579585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 W TOWNSHIP LINE RD",
            "city": "HAVERTOWN",
            "state": "PA",
            "postal_code": "190835215",
            "telephone_number": "610-449-3344",
            "fax_number": "610-449-1325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 W TOWNSHIP LINE RD",
            "city": "HAVERTOWN",
            "state": "PA",
            "postal_code": "190835215",
            "telephone_number": "610-449-3344",
            "fax_number": "610-449-1325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEACOCK",
        "first_name": "MARIANNE",
        "middle_name": "LYNN RAVERT",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-25",
        "last_updated": "2014-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "PA",
            "license": "SC006134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Partners in Care at Home LLC
• Nikita Sunil Patel, PT, DPT
• Michael Andrew Patton, R.PH
• Katie Paugh, M.S. OTR/L
• Paul a. Lotke M.D., P.C.
• Penn Therapy Associates, Inc.
• Pennsylvania CVS Pharmacy, L.L.C. (CVS Pharmacy #00147)
• Pennsylvania CVS Pharmacy, L.L.C. (CVS Pharmacy #01237)
• Perinatal Cardiology Consultants
• Lorene Renee Peta, LPC

• Foot & Ankle Surgery Podiatrist in Havertown, PA
• Providers in Havertown, PA by specialty
• Foot & Ankle Surgery Podiatrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.