Kaley Ellyn Peek, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

8242 Issued in SC

Practice address

420 S Main St
Woodruff, SC 29388-2117

Phone

(864) 476-3212

Fax

(864) 602-2162

NPI assigned

Jun 26, 2013

Last updated

Sep 30, 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

Enrolled in SC

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Prime Dental of Woodruff

  • Dentist
  • Woodruff, SC
  • NPI 1407918014
  NPD (past)
• Progrin Dental of Woodruff LLC

  dba ProGrin Dental

  • General Practice Dentistry
  • Woodruff, SC
  • NPI 1730442310
  NPD (past)

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

{
    "created_epoch": "1372204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412035200000",
    "number": "1386084184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 S MAIN ST",
            "city": "WOODRUFF",
            "state": "SC",
            "postal_code": "293882117",
            "telephone_number": "864-476-3212",
            "fax_number": "864-602-2162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 S MAIN ST",
            "city": "WOODRUFF",
            "state": "SC",
            "postal_code": "293882117",
            "telephone_number": "864-476-3212",
            "fax_number": "864-602-2162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEEK",
        "first_name": "KALEY",
        "middle_name": "ELLYN",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-26",
        "last_updated": "2014-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "8242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Parker Road Drugs (Parker Medical Equipment)
• Parker Road Drugs, Inc. (Parker Medical Equipment)
• Patton Pharmacy
• Patton Pharmacy, Inc.
• Tiffany Lynn Paxton
• Elizabeth R. Perry, M.A., LPC, LAC
• Piedmont Pediatrics LLC
• Piedmont Pediatrics LLC
• Premise Health of South Carolina Medical PC (Industrial Health Services - Battery Plant)
• Primary Spine and Injury Corp

• General Practice Dentistry in Woodruff, SC
• Providers in Woodruff, SC by specialty
• General Practice Dentistry in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2014; 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.