Active NPI
Kyron Peacock
- Physical Therapist
- Monroe, LA
National Provider Identifier
1447487673
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 00260R
- Practice address
- 6700 Highway 165 N
Monroe, LA 71203-8753 - Phone
- (318) 325-4709
- NPI assigned
- Jun 15, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 00260R | LA | Primary |
Addresses
Primary practice location
6700 Highway 165 N
Monroe, LA 71203-8753
Mailing address
4109 Highway 98 W
Summit, MS 39666-9132
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00260R | LA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1245024000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1245024000000",
"number": "1447487673",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4109 HIGHWAY 98 W",
"city": "SUMMIT",
"state": "MS",
"postal_code": "396669132"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6700 HIGHWAY 165 N",
"city": "MONROE",
"state": "LA",
"postal_code": "712038753",
"telephone_number": "318-325-4709"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEACOCK",
"first_name": "KYRON",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-06-15",
"last_updated": "2009-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "LA",
"license": "00260R",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Monroe, LA
- Fre'Drecia Payne, RSW
- Travis Payne
- Courtney Ashante Payton, RSW
- PDN Nursing, Inc (Nursing PRN)
- Peace of Mind Total Health Car ,LLC
- Kaci J Pearce, WHNP-BC
- Brittney Nicole Pearcy, NP-C/APRN
- Pecan Haven Addiction Recovery Center, LLC
- Pediatric Associates, LLP
- Pediatric Clinic of Northeast la a Medical Corporation
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.