Individual provider Active NPI

Steven D. Peck, D,C

  • Chiropractor
  • Las Vegas, NV
National Provider Identifier
1639249071
Registry record updated Nov 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
B348 Issued in NV
Practice address
4680 S Eastern Ave
Suite B
Las Vegas, NV 89119-6192
Phone
(702) 454-4336
Fax
(702) 454-4268
NPI assigned
Nov 9, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X B348 NV Primary

Addresses

Primary practice location

4680 S Eastern Ave
Suite B
Las Vegas, NV 89119-6192

Mailing address

4680 S Eastern Ave Ste B
Las Vegas, NV 89119-6192
Phone (702) 454-4336

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100916000614 NV Practitioner - Chiropractic 3476678228 Practice locations: Las Vegas, NV

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
B348NVMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Centennial Hills Hospital Medical Center Past Accepting new patients
Sunrise Mountainview Hospital, Inc. Past Accepting new patients
University Medical Center of Southern Nevada Past Accepting new patients
Desert Springs Hospital Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: steven.peck.1@15442.direct.athenahealth.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194566400000",
    "number": "1639249071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4680 S EASTERN AVE STE B",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891196192",
            "telephone_number": "702-454-4336",
            "fax_number": "702-454-4268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4680 S EASTERN AVE",
            "address_2": "SUITE B",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891196192",
            "telephone_number": "702-454-4336",
            "fax_number": "702-454-4268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECK",
        "first_name": "STEVEN",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "D,C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-09",
        "last_updated": "2007-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NV",
            "license": "B348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.