Maureen J. Peacock, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

19165 Issued in TN

Practice address

600 Boones Creek Rd
Jonesborough, TN 37659-5167

Phone

(423) 788-9374

Fax

(423) 788-9377

NPI assigned

Aug 27, 2014

Last updated

Jul 12, 2019By 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

Enrolled in TN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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

• Fast Pace Medical Clinic PLLC

  • Family Medicine Physician
  • Spring Hill, TN
  • NPI 1134452865
  Medicare reassignment NPD
• Rural Health Services Consortium of Upper East Tennessee Inc

  dba Bulls Gap Medical Center

  • Federally Qualified Health Center (FQHC)
  • Bulls Gap, TN
  • NPI 1770583544
  Medicare reassignment NPD
• Summit Medical Group, PLLC

  dba Cool Springs Internal Medicine and Pediatrics

  • Internal Medicine Physician
  • Brentwood, TN
  • NPI 1659090298
  Medicare reassignment NPD
• Fast Pace Medical Clinic PLLC

  • Rural Health Clinic/Center
  • Chapel Hill, TN
  • NPI 1316602774
  NPD
• Rural Health Services Consortium of Upper East Tennessee Inc

  • Federally Qualified Health Center (FQHC)
  • Kingsport, TN
  • NPI 1255130027
  NPD
• Rural Health Services Consortium of Upper East Tennessee Inc

  • Federally Qualified Health Center (FQHC)
  • Rogersville, TN
  • NPI 1679672562
  NPD
• Summit Medical Group PLLC

  dba Summit Medical Group of Oak Ridge

  • Family Medicine Physician
  • Oak Ridge, TN
  • NPI 1437238797
  NPD
• Rural Health Services Consortium of Upper East Tennessee Inc

  dba West Main Medical Center

  • Federally Qualified Health Center (FQHC)
  • Rogersville, TN
  • NPI 1154321966
  NPD (past)

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

{
    "created_epoch": "1409097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562889600000",
    "number": "1649670639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 850",
            "city": "ROGERSVILLE",
            "state": "TN",
            "postal_code": "378570850",
            "telephone_number": "423-788-9374",
            "fax_number": "423-921-1681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 BOONES CREEK RD",
            "city": "JONESBOROUGH",
            "state": "TN",
            "postal_code": "376595167",
            "telephone_number": "423-788-9374",
            "fax_number": "423-788-9377"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4307 Highway 66 S",
            "address_purpose": "LOCATION",
            "city": "Rogersville",
            "state": "TN",
            "postal_code": "378573155",
            "country_code": "US",
            "telephone_number": "423-921-1600",
            "fax_number": "423-921-1681",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEACOCK",
        "first_name": "MAUREEN",
        "middle_name": "J.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-27",
        "last_updated": "2019-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "19165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather A Osborne, LCSW
• Wendy Gail Owens, CPM
• Anisha Patel
• Patrick D. Shorter (Jonesborough Eye Clinic)
• Morris Patton
• John C. Pennington, M.A., CCC-SLP
• Petersen Family Chiropractic
• Howard Gale Petersen, DC
• Abigail Rae Phillips, LMSW
• Susan Moore Phillips, RN

• Family Nurse Practitioner in Jonesborough, TN
• Providers in Jonesborough, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.