Edward Arnold Peck III, PH.D.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

0810000910 Issued in VA

Practice address

2010 Bremo Rd
Suite 127
Richmond, VA 23226-2444

Phone

(804) 285-2555

Fax

(804) 282-0314

NPI assigned

May 25, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Neuropsychological Services of Virginia, Inc.

  • Clinical Psychologist
  • Richmond, VA
  • NPI 1487668448
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224115200000",
    "number": "1811943830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2010 BREMO RD",
            "address_2": "SUITE 127",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232262444",
            "telephone_number": "804-285-2555",
            "fax_number": "804-282-0314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 BREMO RD",
            "address_2": "SUITE 127",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232262444",
            "telephone_number": "804-285-2555",
            "fax_number": "804-282-0314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECK",
        "first_name": "EDWARD",
        "middle_name": "ARNOLD",
        "name_suffix": "III",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2008-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "VA",
            "license": "0810000910",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810000910",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "2228",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007705948",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "018091",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SENTARA MENTAL HEALTH",
            "identifier": "087976",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samuel Pearson, PT, DPT
• Sherri Pearson, OTR/L, ATP
• Michael Pease, LCSW
• Austin Ellerbe Peat, MD
• Mary Ann Peberdy, M.D.
• Kristin Peck
• Meredith Peck
• Suzanne K Peck, MD
• Tami Ynette Peckham, LCSW
• Jason Harry Pecorella, MD

• Clinical Neuropsychologist in Richmond, VA
• Providers in Richmond, VA by specialty
• Clinical Neuropsychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.