Ashly Jane Peck, PA-C, ATC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

12929506-1206 Issued in UT

Practice address

1680 W Reunion Ave Ste 5a
South Jordan, UT 84095-4620

Phone

(385) 361-3001

NPI assigned

Aug 11, 2022

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Specialty

Physician Assistant

Education

Other, 2026

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1660176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788912000000",
    "number": "1902534522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1680 W REUNION AVE STE 5A",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840954620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1680 W REUNION AVE STE 5A",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840954620",
            "telephone_number": "385-361-3001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "75 E 12300 S Ste 100",
            "address_purpose": "LOCATION",
            "city": "Draper",
            "state": "UT",
            "postal_code": "840208073",
            "country_code": "US",
            "telephone_number": "801-422-4636",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PECK",
        "first_name": "ASHLY",
        "middle_name": "JANE",
        "credential": "PA-C, ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-11",
        "last_updated": "2026-09-09",
        "certification_date": "2026-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "12929506-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rodney G Payne, D.D.S., M.S.
• Shylo Victoria Payne, FNP-C
• Peach Tree Counseling, LLC
• Peak 5 Family Dentistry
• Stephanie Lorraine Pearce
• Taeya Peck
• Tyler Peck, DPT
• Kathryn A Penderghast, CBD
• Shawn M Pendleton, PA-C
• Brittany Permenter, ACMHC

• Physician Assistant in South Jordan, UT
• Providers in South Jordan, UT by specialty
• Physician Assistant in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2026; 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.
• 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.