David W Peace, BS

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

4915 Issued in OK

Practice address

1104 W Delaware Ave
Vinita, OK 74301-3922

Phone

(918) 323-0777

NPI assigned

May 3, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Bachelor of Science

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 and National Provider Directory roles.

• Community Pathways Unlimited Inc

  • Clinical Psychologist
  • Oklahoma City, OK
  • NPI 1659328284
  Medicare reassignment NPD

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415750400000",
    "number": "1679795124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1104 W DELAWARE AVE",
            "city": "VINITA",
            "state": "OK",
            "postal_code": "743013922",
            "telephone_number": "918-323-0777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1104 W DELAWARE AVE",
            "city": "VINITA",
            "state": "OK",
            "postal_code": "743013922",
            "telephone_number": "918-323-0777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEACE",
        "first_name": "DAVID",
        "middle_name": "W",
        "credential": "BS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-03",
        "last_updated": "2014-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OK",
            "license": "4915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacob Joel Parker
• Laytin Allen Parker
• Deborah Pate
• Timothy Michael Patrick, LPC
• Deborah M. Payton, LADC
• Pam K Pearsall, MS
• Devon Pedersen-Davis
• Reginald A Perry
• Shelby Dell Perry
• Carol Lynn Peters, COTA/L

• Professional Counselor in Vinita, OK
• Providers in Vinita, OK by specialty
• Professional Counselor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2014; 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.