Peggy's Place, LLC

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

Legal business name

PEGGY'S PLACE, LLC

Doing business as

Peggy's Place Adult Life Center

Practice address

1730 Audubon Dr Ste 100
New Albany, IN 47150-3482

Phone

(812) 590-2857

Fax

(888) 544-7301

NPI assigned

Mar 26, 2019

Last updated

Mar 26, 2019By the provider in NPPES

Organization subpart

Yes

Parent organization

PEGGY'S PLACE, LLCAs reported in NPPES

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

Authorized official

Name

Tracy Diers, RN

Title

President

Phone

(812) 913-4308

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Peggy's Place Adult Life Center Doing business as

Part of

Peggy's Place LLC

Locations

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

{
    "created_epoch": "1553558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553558400000",
    "number": "1760943575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1730 AUDUBON DR STE 100",
            "city": "NEW ALBANY",
            "state": "IN",
            "postal_code": "471503482",
            "telephone_number": "812-590-2857",
            "fax_number": "888-544-7301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1730 AUDUBON DR STE 100",
            "city": "NEW ALBANY",
            "state": "IN",
            "postal_code": "471503482",
            "telephone_number": "812-590-2857",
            "fax_number": "888-544-7301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEGGY'S PLACE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PEGGY'S PLACE, LLC",
        "enumeration_date": "2019-03-26",
        "last_updated": "2019-03-26",
        "status": "A",
        "authorized_official_last_name": "DIERS",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "812-913-4308",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300006752",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VETERAN'S AFFAIRS",
            "identifier": "VA249-17-A-0044",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Peggy's Place Adult Life Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kira M Patterson
• Andrea Peake
• Pediatric Associates of Southern Indiana
• Pediatric Specialty Rehab, Inc.
• Ruth Pedrosa
• Jennifer Ann-Marie Pehl, MD
• Tara Sharie Pemberton, APRN
• Kumiko Peoples, COTA
• Kaylea J. Percal, OD
• Carolina Maria Perez, DPM

• Adult Day Care Clinic/Center in New Albany, IN
• Providers in New Albany, IN by specialty
• Adult Day Care Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2019; 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.