Janine Peacock, D.P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

22352 Issued in MD

Practice address

11813 Park Waldorf LN Ste 522
Waldorf, MD 20601-3191

Phone

(240) 718-8103

NPI assigned

Jul 14, 2008

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

Enrolled in MD

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Peacock Physical Therapy Services LLC

  • Physical Therapist
  • Waldorf, MD
  • NPI 1881934453
  NPD Authorized official

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

{
    "created_epoch": "1215993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529452800000",
    "number": "1891959334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1066",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206041066",
            "telephone_number": "240-718-8103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11813 PARK WALDORF LN STE 522",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206013191",
            "telephone_number": "240-718-8103"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11750 Business Park Dr",
            "address_2": "SUITE 203",
            "address_purpose": "LOCATION",
            "city": "Waldorf",
            "state": "MD",
            "postal_code": "206012907",
            "country_code": "US",
            "telephone_number": "240-718-8103",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEACOCK",
        "first_name": "JANINE",
        "name_prefix": "Dr.",
        "credential": "D.P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-14",
        "last_updated": "2018-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "22352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jada S Payne
• Peace & Positivity Mental Health Services, LLC
• Peace & Positivity Mental Health Services, LLC
• Peace of Mind Therapeutic Services, LLC
• Peacock Physical Therapy Services LLC
• Michael Edward Pearlman, DPM
• Jessica Peck, PSYD
• Pediatric Partners of Southern Maryland, PA
• Pediatric Speech Lab
• Pediatric Speech Lab

• Physical Therapist in Waldorf, MD
• Providers in Waldorf, MD by specialty
• Physical Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.