Carly Peacock, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA105307 Issued in FL

Practice address

13720 Old Saint Augustine Rd Ste 4
Jacksonville, FL 32258-7415

Phone

(904) 268-9100

Fax

(904) 268-9700

NPI assigned

Aug 27, 2024

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Bartram Chiropractic Inc

  • Chiropractor
  • Jacksonville, FL
  • NPI 1871244178
  NPD
• Bartram Family Chiropractic Inc

  • Chiropractor
  • Jacksonville, FL
  • NPI 1497035141
  NPD

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

{
    "created_epoch": "1724716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1700610367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9785 CROSSHILL BLVD STE 108",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322225889",
            "telephone_number": "904-268-9100",
            "fax_number": "904-268-9700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13720 OLD SAINT AUGUSTINE RD STE 4",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322587415",
            "telephone_number": "904-268-9100",
            "fax_number": "904-268-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEACOCK",
        "first_name": "CARLY",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-27",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA105307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peachesnabasket Adult Health Services
• John Thomas Peachey, PSY.D.
• Peacock Companion & Caregiving Serivce
• Kerrie Peacock-Preston, PA-C
• Amanda B Peacock, ACNP
• Karlee Peacock
• Lisa Lynn3 Peacock
• Mark Allen Peacock, M.D.
• Mary Ann Marie Peacock, ARNP
• Sarah Peacock, ARNP

• Massage Therapist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Massage Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2024; 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.