John Edward Peacock III, D.O.

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

License

OS014770 Issued in PA

Practice address

10000 Shannondell Dr
Audubon, PA 19403-5615

Phone

(610) 728-5241

Fax

(610) 728-5322

NPI assigned

Nov 7, 2006

Last updated

Jun 3, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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.

• Main Line Healthcare

  • Family Medicine Physician
  • Newtown Square, PA
  • NPI 1922077643
  Medicare reassignment NPD
• PA Department of Military and Veterans Affairs

  dba Delaware Valley Veterans Home

  • Nursing Facility/Intermediate Care Facility
  • Philadelphia, PA
  • NPI 1578672796
  Medicare reassignment NPD
• Department of Military Affairs Commonwealth of Pennsylvania

  dba Gino Merli Veterans' Center Pharmacy

  • Long Term Care Pharmacy
  • Scranton, PA
  • NPI 1104181189
  NPD
• Department of Military Affairs Commonwealth of Pennsylvania

  dba Southeastern PA Veterans Center

  • Nursing Facility/Intermediate Care Facility
  • Spring City, PA
  • NPI 1285726950
  NPD (past)

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401753600000",
    "number": "1881763613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10000 SHANNONDELL DR",
            "city": "AUDUBON",
            "state": "PA",
            "postal_code": "194035615",
            "telephone_number": "610-728-5241",
            "fax_number": "610-728-5322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 SHANNONDELL DR",
            "city": "AUDUBON",
            "state": "PA",
            "postal_code": "194035615",
            "telephone_number": "610-728-5241",
            "fax_number": "610-728-5322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEACOCK",
        "first_name": "JOHN",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2014-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS014770",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "PA",
            "license": "OS014770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bohng G Oh
• John D Oros, RN
• Natu R Patel, M.D
• Nila Patel
• Nilesh V. Patel, MD
• Bryn Pearson, IBCLC
• Penn Medicine-Pma
• Penn Medicine-Pma
• Pennsylvania CVS Pharmacy, L.L.C. (CVS Pharmacy # 05898)
• Julia Pijawka

• Geriatric Medicine (Family Medicine) Physician in Audubon, PA
• Providers in Audubon, PA by specialty
• Geriatric Medicine (Family Medicine) Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2014; 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.