Individual provider Active NPI

Callie Michelle Peck, NP

  • Nurse Practitioner
  • Cumming, GA
National Provider Identifier
1730835687
Registry record updated Aug 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN244865 Issued in GA
Practice address
1505 Northside Blvd Ste 4600
Cumming, GA 30041-7658
Phone
(770) 205-5292
NPI assigned
Mar 1, 2022
Last updated
Aug 22, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN244865 GA Primary
Registered Nurse 163W00000X RN244865 GA

Addresses

Primary practice location

1505 Northside Blvd Ste 4600
Cumming, GA 30041-7658

Mailing address

1505 Northside Blvd Ste 4600
Cumming, GA 30041-7658
Phone (770) 205-5292

Other practice location 1

1365 Clifton Rd NE
Atlanta, GA 30322-1013
Phone (404) 778-3478

Other names 1

  • Callie Michelle Parker Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20220825000918 GA Practitioner - Nurse Practitioner 4284018227 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Emory University School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
NSH Cancer Institute Professional Services a, LLCGroup PAC ID 1557514247, 41 clinicians

Practice addresses (Care Compare)

1505 Northside Blvd
Suite 4600
Cumming, GA 30041-7658
Phone (770) 205-5292

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN244865GAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
NSH Cancer Institute Professional Services a LLC CurrentSince Oct 2, 2023 Accepting new patients
NSH Cancer Institute Professional Services a LLC CurrentSince Oct 2, 2023 Accepting new patients

Locations

1498 Klondike Rd SW
Ste 106
Conyers, GA 30094
Phone (770) 761-7260

1505 Northside Blvd
Ste 4600
Cumming, GA 30041
Phone (770) 205-5292

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1646092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755820800000",
    "number": "1730835687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 NORTHSIDE BLVD STE 4600",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300417658",
            "telephone_number": "770-205-5292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 NORTHSIDE BLVD STE 4600",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300417658",
            "telephone_number": "770-205-5292"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1365 Clifton Rd NE",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303221013",
            "country_code": "US",
            "telephone_number": "404-778-3478",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PECK",
        "first_name": "CALLIE",
        "middle_name": "MICHELLE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-01",
        "last_updated": "2025-08-22",
        "certification_date": "2025-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN244865",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN244865",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CALLIE",
            "last_name": "PARKER",
            "middle_name": "MICHELLE",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cumming, GA

Sources for this page

Verify at the official NPI Registry.