Linda Peck

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

096003871 Issued in IL

Practice address

509 Hamacher St
Waterloo, IL 62298-1592

Phone

(618) 939-5555

NPI assigned

Feb 17, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1424131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424131200000",
    "number": "1821489477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2322 RUSSELL BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631042609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 HAMACHER ST",
            "city": "WATERLOO",
            "state": "IL",
            "postal_code": "622981592",
            "telephone_number": "618-939-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECK",
        "first_name": "LINDA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-02-17",
        "last_updated": "2015-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MO",
            "license": "2014020186",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IL",
            "license": "096003871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ginny M Peter, CPNP
• Olivia Peterson, RSA

• Athletic Trainer in Waterloo, IL
• Providers in Waterloo, IL by specialty
• Athletic Trainer in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2015; 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.