Lisa Lynn3 Peacock

Primary specialty

Health EducatorTaxonomy code 174H00000X

Practice address

10423 Centurion Pkwy N
Jacksonville, FL 32256-0527

Phone

(904) 854-2000

NPI assigned

Jul 4, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Lisa Lynne Peabody Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• The Young Men'S Christian Association of Florida'S First Coast, Inc

  • Health Educator
  • Jacksonville, FL
  • NPI 1558810994
  NPD (past)

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

{
    "created_epoch": "1530662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530662400000",
    "number": "1578059309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 E ADAMS ST STE 210",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322023356",
            "telephone_number": "904-265-1810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10423 CENTURION PKWY N",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322560527",
            "telephone_number": "904-854-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEACOCK",
        "first_name": "LISA",
        "middle_name": "LYNN3",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-04",
        "last_updated": "2018-07-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "PEABODY",
            "middle_name": "LYNNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Peacock Companion & Caregiving Serivce
• Kerrie Peacock-Preston, PA-C
• Amanda B Peacock, ACNP
• Carly Peacock, LMT
• Karlee Peacock
• Mark Allen Peacock, M.D.
• Mary Ann Marie Peacock, ARNP
• Sarah Peacock, ARNP
• Kathleen Elizabeth Peaden
• Peak Performance Chiropractic & Sports Medicine, LLC

• Health Educator in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Health Educator in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 2018; 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.