William Peacock

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC1999 Issued in FL

Legal business name

WILLIAM PEACOCK

Practice address

2255 Highway 71
Marianna, FL 32448-2541

Phone

(850) 526-0067

Fax

(850) 526-0069

NPI assigned

Oct 30, 2014

Organization subpart

No

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

Authorized official

Name

William Stan Peacock, ODNPI 1851451462

Title

Owner

Phone

(850) 526-0067

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• William Stan Peacock, O.D.

  • Optometrist
  • Marianna, FL
  • NPI 1851451462
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1414627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465516800000",
    "number": "1437554623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2255 HIGHWAY 71",
            "city": "MARIANNA",
            "state": "FL",
            "postal_code": "324482541",
            "telephone_number": "850-526-0067",
            "fax_number": "850-526-0069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2255 HIGHWAY 71",
            "city": "MARIANNA",
            "state": "FL",
            "postal_code": "324482541",
            "telephone_number": "850-526-0067",
            "fax_number": "850-526-0069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM PEACOCK",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-30",
        "last_updated": "2016-06-10",
        "status": "A",
        "authorized_official_last_name": "PEACOCK",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "STAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "850-526-0067",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC1999",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTOMETRY BRANCH LICENSE",
            "identifier": "OPC1999",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley B. Wester, A.R.N.P
• Hanna Donofro Wheetley, OTR/L
• Pamela Tripp White
• Jantzen Wayne Whitehead, MS
• Glinda Whittaker, LPTA, LMT
• Jason Williams
• Jennifer B Wood, APRN
• Jacques N Worlds, MSW
• Philip Yoder, ARNP
• Linda D. Youmas, LCSW

• Optometrist in Marianna, FL
• Providers in Marianna, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.