Individual provider Active NPI

Holly Ann Peckskamp, CPM

  • Midwife
  • Nashville, TN
National Provider Identifier
1558192559
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
MidwifeTaxonomy code 176B00000X
License
149 Issued in TN
Practice address
4415 Milesdale CT
Nashville, TN 37204-4127
Phone
(508) 789-7718
NPI assigned
Aug 12, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Midwife 176B00000X 149 TN Primary

Addresses

Primary practice location

4415 Milesdale CT
Nashville, TN 37204-4127

Mailing address

4415 Milesdale CT
Nashville, TN 37204-4127
Phone (508) 789-7718

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

LicenseStateTypeSpecialty
149TNMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1723420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1558192559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4415 MILESDALE CT",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372044127",
            "telephone_number": "508-789-7718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4415 MILESDALE CT",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372044127",
            "telephone_number": "508-789-7718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECKSKAMP",
        "first_name": "HOLLY",
        "middle_name": "ANN",
        "credential": "CPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-12",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "TN",
            "license": "149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2024; 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.