Amy Peck, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

3139 Issued in WI

Practice address

2020 S Muskego Ave
Milwaukee, WI 53204-3622

Phone

(414) 383-2630

NPI assigned

Oct 12, 2021

Last updated

Nov 9, 2021By the provider in NPPES

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

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": "1633996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636416000000",
    "number": "1578225082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 S MUSKEGO AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532043622",
            "telephone_number": "414-383-2630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 S MUSKEGO AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532043622",
            "telephone_number": "414-383-2630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECK",
        "first_name": "AMY",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-12",
        "last_updated": "2021-11-09",
        "certification_date": "2021-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "3139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayla Pease
• Nora Pecha
• Leroy L Peche, M.S.W.
• Jessica L. Pecherski, AA-C
• Matthew H. Pecherski, AA-C
• Susan J Peck, APNP
• Jo Anne Pedersen, MSW
• Jessica Dee Pederson
• Elizabeth Anne Pedi, DPT
• Pediatric and Adult Medicine Associates S.C.

• Physical Therapy Assistant in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Physical Therapy Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2021; 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.