Sumerlyn Peckham, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN11020408 Issued in FL

Practice address

722 S Atlantic Ave Ste a
Ormond Beach, FL 32176-7898

Phone

(386) 267-0831

Fax

(386) 267-0796

NPI assigned

Jun 27, 2022

Sex

Female

Sole proprietor

Yes

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

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.

Opted out of Medicare

Yes, effective May 22, 2025 through May 22, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1656288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745539200000",
    "number": "1750013843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 KENT DR",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321767825",
            "telephone_number": "334-714-8889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "722 S ATLANTIC AVE STE A",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321767898",
            "telephone_number": "386-267-0831",
            "fax_number": "386-267-0796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECKHAM",
        "first_name": "SUMERLYN",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-27",
        "last_updated": "2025-04-25",
        "certification_date": "2025-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11020408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michele Patterson-Bauman, APRN
• PBH Professional Group, P.a. (PATH 5Palms Professional Group)
• Peace of Mind--Beachside (Beachside)
• Pearl Family Chiropractic LLC
• Deborah S Pechacek, RPH
• Pecks Family Practice PLC
• Pediatric Therapy of Ormond, LLC
• Pediatric Therapy of Ormond, LLC
• Pediatric Urgent Care Group of Ormond Beach (Twilight Pediatrics)
• Pediatric Urgent Care Group of Ormond Beach (Twilight Pediatrics)

• Family Nurse Practitioner in Ormond Beach, FL
• Providers in Ormond Beach, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.