Individual provider Active NPI

Catherine L. Peacock, RN, APRN

  • Adult Health Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1760532295
Registry record updated Jan 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
AP180 Issued in AZ
Practice address
9515 W Camelback Rd
Suite 102
Phoenix, AZ 85037-1355
Phone
(623) 772-6999
Fax
(623) 772-6444
NPI assigned
Jan 10, 2007
Last updated
Jan 12, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X AP180 AZ Primary

Addresses

Primary practice location

9515 W Camelback Rd
Suite 102
Phoenix, AZ 85037-1355

Mailing address

3815 E Bell Rd
Suite 2300
Phoenix, AZ 85032-2122
Phone (602) 931-4586

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
180AZMDOptometrist
AP180AZMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sun Health MRI Center Past Accepting new patients
Ipn of Arizona, PLC Past Accepting new patients
Privia Medical Group Arizona, LLC Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231718400000",
    "number": "1760532295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3815 E BELL RD",
            "address_2": "SUITE 2300",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850322122",
            "telephone_number": "602-931-4586",
            "fax_number": "602-931-4591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9515 W CAMELBACK RD",
            "address_2": "SUITE 102",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850371355",
            "telephone_number": "623-772-6999",
            "fax_number": "623-772-6444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEACOCK",
        "first_name": "CATHERINE",
        "middle_name": "L.",
        "credential": "RN, APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-10",
        "last_updated": "2009-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AZ",
            "license": "AP180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2009; 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.