Susan Peacock, M.S.,R.D.,LDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

ND3521 Issued in FL

Practice address

2240 W Woolbright Rd Ste 305
Boynton Beach, FL 33426-6363

Phone

(561) 758-1734

Fax

(561) 540-5186

NPI assigned

Feb 12, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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.

• Susgen Health Network Inc.

  • Registered Dietitian
  • Lantana, FL
  • NPI 1750580767

  Dietitian, Registered

  Medicare reassignment NPD Authorized official
• E-Z Diabetes Management LLC

  • Metabolic Nutrition Registered Dietitian
  • Jupiter, FL
  • NPI 1245438381
  NPD (past)
• Fay Nutrition

  • Registered Dietitian
  • San Francisco, CA
  • NPI 1104334465

  Dietitian, Registered

  NPD (past)

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655510400000",
    "number": "1699816504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 WATERWAY DR S APT 203",
            "city": "LANTANA",
            "state": "FL",
            "postal_code": "334621827",
            "telephone_number": "561-758-1734",
            "fax_number": "561-540-5186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2240 W WOOLBRIGHT RD STE 305",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334266363",
            "telephone_number": "561-758-1734",
            "fax_number": "561-540-5186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEACOCK",
        "first_name": "SUSAN",
        "name_prefix": "Ms.",
        "credential": "M.S.,R.D.,LDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-12",
        "last_updated": "2022-06-18",
        "certification_date": "2022-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "FL",
            "license": "ND3521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "GetHealthie",
            "affiliation": "N",
            "endpointDescription": "HIPAA Compliant Platform",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2240 W Woolbright Rd Ste 305",
            "city": "Boynton Beach",
            "state": "FL",
            "country_code": "US",
            "postal_code": "334266363",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Latina Lashelle Pechmann

• Registered Dietitian in Boynton Beach, FL
• Providers in Boynton Beach, FL by specialty
• Registered Dietitian in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.