Individual provider Active NPI

Schquthia Fearrington Peacock, FNP

  • Family Nurse Practitioner
  • Cary, NC
National Provider Identifier
1720182421
Registry record updated Aug 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
201274 Issued in NC
Practice address
110 Preston Executive Dr # a
Cary, NC 27513-8457
Phone
(919) 319-9219
Fax
(919) 481-1716
NPI assigned
Sep 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 201274 NC Primary

Addresses

Primary practice location

110 Preston Executive Dr # a
Cary, NC 27513-8457

Mailing address

110 Preston Executive Dr # a
Cary, NC 27513-8457
Phone (919) 319-9219

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041215000836 NC Practitioner - Nurse Practitioner 0143287037 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of North Carolina at Chapel Hill School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Avance Care PAGroup PAC ID 3577634476, 244 clinicians

Practice addresses (Care Compare)

3600 NW Cary Pkwy
Suite 104
Cary, NC 27513-8444
Phone (919) 319-9219

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
201274NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Avance Care, PA CurrentSince Apr 1, 2022 Accepting new patients

Locations

115 Crescentcommons Dr
Ste 100
Cary, NC 27518
Phone (919) 467-5678

3600 NW Cary Pkwy
Ste 104
Cary, NC 27513
Phone (919) 319-9219

7510 Ramble Way
Ste 107
Raleigh, NC 27616
Phone (919) 277-8880

Interoperability endpoints

  • Direct secure messaging: speacock35095@fastmed.direct-ci.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1158019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534204800000",
    "number": "1720182421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 PRESTON EXECUTIVE DR # A",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275138457",
            "telephone_number": "919-319-9219",
            "fax_number": "919-481-1716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 PRESTON EXECUTIVE DR # A",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275138457",
            "telephone_number": "919-319-9219",
            "fax_number": "919-481-1716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEACOCK",
        "first_name": "SCHQUTHIA",
        "middle_name": "FEARRINGTON",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-12",
        "last_updated": "2018-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "201274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cary, NC

Sources for this page

Verify at the official NPI Registry.