Joanne Peck, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

200101262 Issued in NC

Practice address

14 Doctors Cir
Suite 3
Supply, NC 28462-4097

Phone

(910) 754-7075

Fax

(910) 754-2158

NPI assigned

Aug 13, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Shore Fun Pediatrics

  • Pediatrics Physician
  • Supply, NC
  • NPI 1750420428
  NPD (past)
• Whiteville Medical Associates PA

  • Family Medicine Physician
  • Whiteville, NC
  • NPI 1902963937

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1790797108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 DOCTORS CIR",
            "address_2": "SUITE 3",
            "city": "SUPPLY",
            "state": "NC",
            "postal_code": "284624097",
            "telephone_number": "910-754-7075",
            "fax_number": "910-754-2158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 DOCTORS CIR",
            "address_2": "SUITE 3",
            "city": "SUPPLY",
            "state": "NC",
            "postal_code": "284624097",
            "telephone_number": "910-754-7075",
            "fax_number": "910-754-2158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECK",
        "first_name": "JOANNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-13",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "200101262",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE PROVIDER NUMBER",
            "identifier": "20-0109889",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA IND PROVIDER NUMBER",
            "identifier": "7031690",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC IND PROVIDER NUMBER",
            "identifier": "1200360",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8912935",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC IND PROVIDER",
            "identifier": "12932",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST IND PROVIDER #",
            "identifier": "C7595",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly Palmer, LCSW-C, LCSW
• Palmetto Sleep Lab LLC
• Palms Health and Wellness,LLC
• Tina Paxton-Peeks
• Casey Madeline Payne
• Maizey Dawn Peek, LCSWA
• Amanda M Peters
• Joan Shelton Phillips, FNPBC
• Nyisha Powell, CFPS
• Wendy Mechell Price, COTA/L

• Pediatrics Physician in Supply, NC
• Providers in Supply, NC by specialty
• Pediatrics Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.