Kimberly H Peacock

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN230391 Issued in GA

Practice address

4015 Veterans CT Ste C
Columbus, GA 31909-2540

Phone

(706) 221-7005

NPI assigned

May 24, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1495584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748476800000",
    "number": "1871021600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4015 VETERANS CT STE C",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319092540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4015 VETERANS CT STE C",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319092540",
            "telephone_number": "706-221-7005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEACOCK",
        "first_name": "KIMBERLY",
        "middle_name": "H",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-24",
        "last_updated": "2025-05-29",
        "certification_date": "2025-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN230391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Latanja Peabody
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• Peaceful River Home Care Agency
• Peaceful River Residential Services
• Peach Gardens Private Home Care
• Leslie Peacock, PHARMD
• Bret Kyle Pearce, D.O.
• Carol Pearson, CNNP
• Reginald Dwayne Pearson
• Ram R Peddada, M.D., D.SC.

• Family Nurse Practitioner in Columbus, GA
• Providers in Columbus, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2025; 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.