NPIMap

Individual provider Active NPI

Emily Elizabeth Peacock, MD

  • Family Medicine Physician
  • Harrisburg, NC
National Provider Identifier
1821475484
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2018-00302 Issued in NC
Practice address
4315 Physicians Blvd
Ste 101
Harrisburg, NC 28075-7430
Phone
(704) 455-6521
NPI assigned
May 4, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2018-00302 NC Primary

Addresses

Primary practice location

4315 Physicians Blvd
Ste 101
Harrisburg, NC 28075-7430

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

270 Copperfield Blvd NE
Ste 102
Concord, NC 28025-2441
Phone (704) 786-6521

Other practice location 2

123 Professional Park Dr
Locust, NC 28097-7712
Phone (704) 403-6760

Other practice location 3

8560 Cook St
Mount Pleasant, NC 28124-7686
Phone (704) 436-6521

Other practice location 4

5641 Poplar Tent Rd
Ste 101
Concord, NC 28027-7533
Phone (704) 782-1955

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address epeacock136762@CarolinasHealthcareSystem.direct-ci.com Atrium Health
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180822000163 NC Practitioner - Family Practice 5092029868 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Cincinnati College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolinas Physicians Network IncGroup PAC ID 3375449655, 2,324 clinicians

Practice addresses (Care Compare)

4315 Physicians Blvd
Suite 101
Harrisburg, NC 28075-7431
Phone (704) 455-6521

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2018-00302NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cabarrus Rowan Community Health Centers, Inc. Family Medicine Current Accepting new patients
Cabarrus Rowan Community Health Centers, Inc. Family Medicine CurrentSince Aug 1, 2020 Accepting new patients
Cabarrus Rowan Community Health Centers, Inc. CurrentSince Aug 1, 2020 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Carolinas Physicians Network Inc CurrentSince Aug 6, 2018 Accepting new patients
Carolinas Physicians Network Inc Family Medicine CurrentSince Aug 6, 2018 Accepting new patients
Carolinas Physicians Network, Inc Family Medicine Past Accepting new patients

Locations

100 N 6th St
Ste 900A
Minneapolis, MN 55403

5727 Prosperity Crossing Dr
Ste 2200
Charlotte, NC 28269
Phone (704) 618-7894

5435 Prosperity Church Rd
Ste 2200
Charlotte, NC 28269
Phone (704) 863-9830

5641 Poplar Tent Rd
Ste 101
Concord, NC 28027
Phone (704) 782-1955

270 Copperfield Blvd NE
Ste 102
Concord, NC 28025
Phone (704) 721-2060

202D McGill Ave NW
Concord, NC 28025
Phone (704) 792-2242

4315 Physicians Blvd
Ste 101
Harrisburg, NC 28075
Phone (704) 455-6521

123 Professional Park Dr
Locust, NC 28097
Phone (704) 403-6760

8560 Cook St
Mt Pleasant, NC 28124
Phone (704) 403-1911

Interoperability endpoints

  • Direct secure messaging: epeacock136762@carolinashealthcaresystem.direct-ci.com
  • Direct secure messaging: emily.peacock.1@12871.direct.athenahealth.com

Organizations & group practices 7

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1430697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1821475484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19305",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282199305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4315 PHYSICIANS BLVD",
            "address_2": "STE 101",
            "city": "HARRISBURG",
            "state": "NC",
            "postal_code": "280757430",
            "telephone_number": "704-455-6521"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "270 Copperfield Blvd NE",
            "address_2": "Ste 102",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NC",
            "postal_code": "280252441",
            "country_code": "US",
            "telephone_number": "704-786-6521",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "123 Professional Park Dr",
            "address_purpose": "LOCATION",
            "city": "Locust",
            "state": "NC",
            "postal_code": "280977712",
            "country_code": "US",
            "telephone_number": "704-403-6760",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8560 Cook St",
            "address_purpose": "LOCATION",
            "city": "Mount Pleasant",
            "state": "NC",
            "postal_code": "281247686",
            "country_code": "US",
            "telephone_number": "704-436-6521",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5641 Poplar Tent Rd",
            "address_2": "Ste 101",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NC",
            "postal_code": "280277533",
            "country_code": "US",
            "telephone_number": "704-782-1955",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEACOCK",
        "first_name": "EMILY",
        "middle_name": "ELIZABETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-04",
        "last_updated": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2018-00302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "epeacock136762@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "4315 Physicians Blvd",
            "address_2": "STE 101",
            "city": "Harrisburg",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280757430",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Harrisburg, NC

Sources for this page

Verify at the official NPI Registry.