Active NPI
Peabody Podiatry LLC
- Foot Surgery Podiatrist
- Peabody, MA
National Provider Identifier
1457543639
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot Surgery Podiatrist
- License
- 1746
- Legal business name
- PEABODY PODIATRY LLC
- Practice address
- 6 Essex Center Dr
Suite 208
Peabody, MA 01960-2910 - Phone
- (978) 531-9969
- NPI assigned
- Aug 13, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Paul S. Peicott, DPM
- Title
- Owner
- Phone
- (978) 531-9969
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot Surgery Podiatrist | 213ES0131X | 1746 | MA | Primary |
Addresses
Primary practice location
6 Essex Center Dr
Suite 208
Peabody, MA 01960-2910
Mailing address
6 Essex Center Dr
Suite 208
Peabody, MA 01960-2910
Phone (978) 531-9969
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
6 Essex Center Dr
Ste 208
Peabody, MA 01960
Phone (978) 531-9969
Interoperability endpoints
- peicott.paul.ppdpm@direct.partners.masshiway.net
- rotondo.r.ppdpm@direct.partners.masshiway.net
- brown.daniel.ppdpm@direct.partners.masshiway.net
- kaminski.justin.ppdpm@direct.partners.masshiway.net
- capozzi.matthew.ppdpm@direct.partners.masshiway.net
Practitioners & affiliated clinicians
Practitioners 5
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186963200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1212364800000",
"number": "1457543639",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6 ESSEX CENTER DR",
"address_2": "SUITE 208",
"city": "PEABODY",
"state": "MA",
"postal_code": "019602910",
"telephone_number": "978-531-9969"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6 ESSEX CENTER DR",
"address_2": "SUITE 208",
"city": "PEABODY",
"state": "MA",
"postal_code": "019602910",
"telephone_number": "978-531-9969"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PEABODY PODIATRY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2007-08-13",
"last_updated": "2008-06-02",
"status": "A",
"authorized_official_last_name": "PEICOTT",
"authorized_official_first_name": "PAUL",
"authorized_official_middle_name": "S.",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "978-531-9969",
"authorized_official_credential": "DPM"
},
"taxonomies": [
{
"code": "213ES0131X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Podiatrist, Foot Surgery",
"state": "MA",
"license": "1746",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Peabody, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2008; 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.