Peacock Family Chiropractic, PLLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2301010287 Issued in MI

Legal business name

PEACOCK FAMILY CHIROPRACTIC, PLLC

Practice address

408 N 3Rd St
Rogers City, MI 49779-1309

Phone

(989) 734-3384

Fax

(989) 734-7391

NPI assigned

Dec 21, 2015

Last updated

Feb 18, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Matthew Joel Peacock, D.C.NPI 1790174456

Title

Chiropractor

Phone

(989) 734-3384

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Matthew Joel Peacock, D.C.

  • Chiropractor
  • Saginaw, MI
  • NPI 1790174456
  Medicare reassignment NPD Authorized official
• Russell Austin Fairbanks, D.C.

  • Chiropractor
  • Rogers City, MI
  • NPI 1528018355
  NPD (past)

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

{
    "created_epoch": "1450656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455753600000",
    "number": "1780049528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 N 3RD ST",
            "city": "ROGERS CITY",
            "state": "MI",
            "postal_code": "497791309",
            "telephone_number": "989-734-3384",
            "fax_number": "989-734-7391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 N 3RD ST",
            "city": "ROGERS CITY",
            "state": "MI",
            "postal_code": "497791309",
            "telephone_number": "989-734-3384",
            "fax_number": "989-734-7391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACOCK FAMILY CHIROPRACTIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-21",
        "last_updated": "2016-02-18",
        "status": "A",
        "authorized_official_last_name": "PEACOCK",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "JOEL",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "989-734-3384",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301010287",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1790174556",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Albert Olree, DC
• Orthopedic Associates of Holland PC (Rhind Orthopedic Evaluation)
• Patrick Joseph Osborn, RPH
• Jennifer Osborne
• Angela Paul
• Brooke Pierson
• Sydney E Purgiel
• Darlene Castro Ragasa, PT
• Michelle Reichenbach, P.T.A.
• Earl Sidney Rhind II, M.D.

• Chiropractor in Rogers City, MI
• Providers in Rogers City, MI by specialty
• Chiropractor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.