Robin Ross Peacock, LSAC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

138819-6006 Issued in UT

Practice address

2127 Lincoln Ave
Ogden, UT 84401-1313

Phone

(801) 625-3686

Fax

(801) 621-4203

NPI assigned

Apr 24, 2007

Sex

Male

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457570277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5961 W 5050 S",
            "city": "HOOPER",
            "state": "UT",
            "postal_code": "843159720",
            "telephone_number": "801-985-9891",
            "fax_number": "801-621-4203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2127 LINCOLN AVE",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844011313",
            "telephone_number": "801-625-3686",
            "fax_number": "801-621-4203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEACOCK",
        "first_name": "ROBIN",
        "middle_name": "ROSS",
        "name_prefix": "Mr.",
        "credential": "LSAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "UT",
            "license": "138819-6006",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "876000308007",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda J. Payne, RN
• Julia D Payne, RN
• Madisen Katherine Payne, MSW, CSW
• Dolly Louise Peach, M.D.
• Alexia Peacock
• Peak Health Clinic LLC
• Peak Medical Clinic, LLC
• Peak Medical of Utah, LLC
• Peaks Advanced Medical
• Kaitlyn Pearl

• Addiction (Substance Use Disorder) Counselor in Ogden, UT
• Providers in Ogden, UT by specialty
• Addiction (Substance Use Disorder) Counselor in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.