Michael McPeak, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

096.005058 Issued in IL

Practice address

1836 S Macarthur Blvd
Springfield, IL 62704-4030

Phone

(217) 546-0512

Fax

(217) 528-9854

NPI assigned

Oct 17, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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": "1571270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571270400000",
    "number": "1699317081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3510 FERRIS DR",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625219164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1836 S MACARTHUR BLVD",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627044030",
            "telephone_number": "217-546-0512",
            "fax_number": "217-528-9854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCPEAK",
        "first_name": "MICHAEL",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-17",
        "last_updated": "2019-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IL",
            "license": "096.005058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "michael.mcpeak@hshs.org",
            "affiliation": "N",
            "endpointDescription": "HSHS work e-mail",
            "address_1": "1836 S MacArthur Blvd",
            "city": "Springfield",
            "state": "IL",
            "country_code": "US",
            "postal_code": "627044030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Amy C McNabb, P.A.
• Kevin Byron McNally, DMD
• Olivia McNamara, RN, BSN
• Bryant McNeely
• Karlee McNeely
• Jessica Marie McRill, APN
• Malaiah McRory
• Kevin McVary, MD
• Whitney Meade, THERAPIST
• Christina L. Meads

• Athletic Trainer in Springfield, IL
• Providers in Springfield, IL by specialty
• Athletic Trainer in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2019; 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.