Active NPI
John Thomas Peachey, PSY.D.
- Clinical Psychologist
- Jacksonville, FL
National Provider Identifier
1669622759
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 0810005144
- Practice address
- 7778 Collins Ridge Blvd
Jacksonville, FL 32244-6420 - Phone
- (415) 269-7953
- NPI assigned
- Sep 24, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 0810005144 | VA | Primary |
Addresses
Primary practice location
7778 Collins Ridge Blvd
Jacksonville, FL 32244-6420
Mailing address
7778 Collins Ridge Blvd
Jacksonville, FL 32244-6420
Phone (415) 269-7953
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0810005144 | VA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1222214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1424995200000",
"number": "1669622759",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7778 COLLINS RIDGE BLVD",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322446420",
"telephone_number": "415-269-7953"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7778 COLLINS RIDGE BLVD",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322446420",
"telephone_number": "415-269-7953"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEACHEY",
"first_name": "JOHN",
"middle_name": "THOMAS",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-09-24",
"last_updated": "2015-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "VA",
"license": "0810005144",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
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- Carly Peacock, LMT
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.