NPIMap

Organization Active NPI

Charles Jeffery Peck, DO, PC

  • Psychologist
  • Colorado Springs, CO
National Provider Identifier
1427317783
Registry record updated May 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
40851 Issued in CO
Legal business name
CHARLES JEFFERY PECK, DO, PC
Practice address
4641 Bridle Pass Dr
Colorado Springs, CO 80923-9266
Phone
(719) 640-4007
NPI assigned
May 8, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2012

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

Authorized official

Name
Charles Jeffery Peck, DO
Title
President
Phone
(719) 640-4007

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X 40851 CO Primary

Addresses

Primary practice location

4641 Bridle Pass Dr
Colorado Springs, CO 80923-9266

Mailing address

4641 Bridle Pass Dr
Colorado Springs, CO 80923-9266
Phone (719) 640-4007

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1336435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336435200000",
    "number": "1427317783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4641 BRIDLE PASS DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809239266",
            "telephone_number": "719-640-4007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4641 BRIDLE PASS DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809239266",
            "telephone_number": "719-640-4007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES JEFFERY PECK, DO, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-08",
        "last_updated": "2012-05-08",
        "status": "A",
        "authorized_official_last_name": "PECK",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "JEFFERY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "719-640-4007",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "CO",
            "license": "40851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2012; 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.