Individual provider Active NPI

Emma Rachel Peck, PA-C

  • Physician Assistant
  • Holly Springs, NC
National Provider Identifier
1497566053
Registry record updated Apr 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-15107 Issued in NC
Practice address
5302 Date Palm LN
Holly Springs, NC 27540-6060
Phone
(919) 453-7138
NPI assigned
Jan 14, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-15107 NC Primary

Addresses

Primary practice location

5302 Date Palm LN
Holly Springs, NC 27540-6060

Mailing address

5302 Date Palm LN
Holly Springs, NC 27540-6060

Other practice location 1

6715 McCrimmon Pkwy Ste 201
Cary, NC 27519-1916
Phone (919) 791-2040

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address epeck1263223@direct.unc.nchie.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250428002351 NC Practitioner - Physician Assistant 3173049632 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Carolina MG LLCGroup PAC ID 1951828847, 723 clinicians

Practice addresses (Care Compare)

4225 Macon Pond Rd
Suite 200
Raleigh, NC 27607-6320
Phone (919) 791-2040

4420 Lake Boone TRL
Raleigh, NC 27607-7505

6715 McCrimmon Pkwy
Cary, NC 27519-1916

781 Avent Ferry Rd
Holly Springs, NC 27540-7776

850 S Main St
Holly Springs, NC 27540-8906
Phone (984) 215-4000

Hospital & facility affiliations

  • Rex Hospital Hospital, Raleigh, NC, CCN 340114

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0010-15107NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rex Hospital Inc Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1736812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745452800000",
    "number": "1497566053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5302 DATE PALM LN",
            "city": "HOLLY SPRINGS",
            "state": "NC",
            "postal_code": "275406060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5302 DATE PALM LN",
            "city": "HOLLY SPRINGS",
            "state": "NC",
            "postal_code": "275406060",
            "telephone_number": "919-453-7138"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6715 McCrimmon Pkwy Ste 201",
            "address_purpose": "LOCATION",
            "city": "Cary",
            "state": "NC",
            "postal_code": "275191916",
            "country_code": "US",
            "telephone_number": "919-791-2040",
            "fax_number": "919-791-2041",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PECK",
        "first_name": "EMMA",
        "middle_name": "RACHEL",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-14",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-15107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "epeck1263223@direct.unc.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "6715 McCrimmon Pkwy Ste 201",
            "city": "Cary",
            "state": "NC",
            "country_code": "US",
            "postal_code": "275191916",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Holly Springs, NC

Sources for this page

Verify at the official NPI Registry.