Individual provider Active NPI

Sirkka Peckenpaug, LPN

  • Licensed Practical Nurse
  • Hanover, MD
National Provider Identifier
1760742829
Registry record updated May 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LPN1003311 Issued in DC
Practice address
7789 Arundel Mills Blvd
Apt # 203
Hanover, MD 21076-1996
Phone
(240) 460-8472
NPI assigned
May 23, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LPN1003311 DC Primary

Addresses

Primary practice location

7789 Arundel Mills Blvd
Apt # 203
Hanover, MD 21076-1996

Mailing address

7789 Arundel Mills Blvd
Apt # 203
Hanover, MD 21076-1996
Phone (240) 460-8472

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LPN1003311DCMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1337731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337731200000",
    "number": "1760742829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7789 ARUNDEL MILLS BLVD",
            "address_2": "APT # 203",
            "city": "HANOVER",
            "state": "MD",
            "postal_code": "210761996",
            "telephone_number": "240-460-8472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7789 ARUNDEL MILLS BLVD",
            "address_2": "APT # 203",
            "city": "HANOVER",
            "state": "MD",
            "postal_code": "210761996",
            "telephone_number": "240-460-8472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECKENPAUG",
        "first_name": "SIRKKA",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-23",
        "last_updated": "2012-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "DC",
            "license": "LPN1003311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hanover, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2012; 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.