Carlie Layne Peacock, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

1-137124 Issued in AL

Practice address

2055 E South Blvd Ste 601
Montgomery, AL 36116-2014

Phone

(334) 747-2999

Fax

(334) 747-7276

NPI assigned

May 4, 2017

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

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in AL

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

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Health Care Authority for Baptist Health, an Affiliate of UabhsGroup PAC ID 8426076670, 270 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Medical Center South Hospital, Montgomery, AL, CCN 010023

Merit-based Incentive Payment System (MIPS)

Final score

83 of 100Reported as group

Quality

64.43

Promoting interoperability

100

Improvement activities

40

Cost

78.9

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Health Care Authority for Baptist Health, an Affiliate of Uabhs

  • Family Medicine Physician
  • Montgomery, AL
  • NPI 1982653390
  Medicare reassignment Care Compare group NPD
• Hospital Physician Services - Southeast Professional Corporation

  • Hospitalist Physician
  • Monroe, GA
  • NPI 1760410385

  AL, Nurse Practitioner

  Medicare reassignment NPD
• Health Care Authority for Baptist Health, an Affiliate of Uabhs

  • Internal Medicine Physician
  • Montgomery, AL
  • NPI 1033534524
  NPD
• Health Care Authority for Baptist Health, an Affiliate of Uabhs

  • Cardiovascular Disease Physician
  • Montgomery, AL
  • NPI 1427822279
  NPD
• The Health Care Authority for Baptist Health an Affiliate of Uabhs

  • General Acute Care Hospital
  • Prattville, AL
  • NPI 1942391230
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Health Care Authority for Baptist Health, an Affiliate of Uabhs

  • General Acute Care Hospital
  • Montgomery, AL
  • NPI 1700977105
  Care Compare affiliation

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

{
    "created_epoch": "1493856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673395200000",
    "number": "1407382864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 BROWN SPRINGS RD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361177005",
            "telephone_number": "334-747-4159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2055 E SOUTH BLVD STE 601",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361162014",
            "telephone_number": "334-747-2999",
            "fax_number": "334-747-7276"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "645 McQueen Smith Rd N Ste 300",
            "address_purpose": "LOCATION",
            "city": "Prattville",
            "state": "AL",
            "postal_code": "360667269",
            "country_code": "US",
            "telephone_number": "334-747-2999",
            "fax_number": "334-747-7276",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEACOCK",
        "first_name": "CARLIE",
        "middle_name": "LAYNE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-04",
        "last_updated": "2023-01-11",
        "certification_date": "2023-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1-137124",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF ALABAMA",
            "identifier": "512-04310",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "A0001K874",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "212224",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF ALABAMA",
            "identifier": "512-04312",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIVA HEALTH",
            "identifier": "Z54221",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Rufus Shanks Pearson Jr., CRNA
• Samuel Lavone Peavy, D.C.
• Stephanie Peavy
• Krista Pedersen, PHARM.D.
• Pediatric Healthcare, LLC

• Nurse Practitioner in Montgomery, AL
• Providers in Montgomery, AL by specialty
• Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.