Mark D Peckham, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

TO2158 Issued in MO

Practice address

600 Westwood Dr S
Mark D Peckham OD
Festus, MO 63028-2061

Phone

(636) 937-4747

Fax

(636) 937-4747

NPI assigned

Sep 27, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Mark D Peckham OD PC

  • Optometrist
  • Festus, MO
  • NPI 1346419645
  NPD (past) Authorized official
• Complete Vision Care, Inc.

  • Optometrist
  • Leadington, MO
  • NPI 1497895908
  NPD (past)

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

{
    "created_epoch": "1127779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1376539064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 WESTWOOD DR S",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630282061",
            "telephone_number": "636-937-4747",
            "fax_number": "636-937-4747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 WESTWOOD DR S",
            "address_2": "MARK D PECKHAM OD",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630282061",
            "telephone_number": "636-937-4747",
            "fax_number": "636-937-4747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECKHAM",
        "first_name": "MARK",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-27",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "TO2158",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PIN",
            "identifier": "6828",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Duk J. Park, M.D.
• Ha Eun Park, DMD
• Alexander Gayle Parker, MD
• Ashutosh H Patel, MD
• Khusbu Patel, DPM
• Teresa Pehle
• Nathanael Perkins
• Matthew S Pesek, DO
• Katherine A Petefish, LMSW, LCPC, BCBA LBA
• Tessa F Peterein

• Optometrist in Festus, MO
• Providers in Festus, MO by specialty
• Optometrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.