Active NPI
Roger Peckham, M.D.
- Endocrinology, Diabetes & Metabolism Physician
- Westlake, OH
National Provider Identifier
1912937194
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endocrinology, Diabetes & Metabolism Physician
- License
- 35-049421
- Practice address
- 29101 Health Campus Dr BLDG 2
Suite 295
Westlake, OH 44145-5270 - Phone
- (440) 808-5950
- Fax
- (440) 250-0363
- NPI assigned
- Jul 4, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endocrinology, Diabetes & Metabolism Physician | 207RE0101X | 35-049421 | OH | Primary |
Addresses
Primary practice location
29101 Health Campus Dr BLDG 2
Suite 295
Westlake, OH 44145-5270
Mailing address
PO Box 8792
Belfast, ME 04915-8792
Phone (440) 808-5950
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0903437 | Medicaid | OH |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | rogerpeckham@uhps.allscriptsdirect.net |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35-049421 | OH | MD | Endocrinology, Diabetes & Metabolism Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151971200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605312000000",
"number": "1912937194",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8792",
"city": "BELFAST",
"state": "ME",
"postal_code": "049158792",
"telephone_number": "440-808-5950",
"fax_number": "440-250-0363"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29101 HEALTH CAMPUS DR BLDG 2",
"address_2": "SUITE 295",
"city": "WESTLAKE",
"state": "OH",
"postal_code": "441455270",
"telephone_number": "440-808-5950",
"fax_number": "440-250-0363"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PECKHAM",
"first_name": "ROGER",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-04",
"last_updated": "2020-11-14",
"certification_date": "2020-11-14",
"status": "A"
},
"taxonomies": [
{
"code": "207RE0101X",
"taxonomy_group": "",
"desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
"state": "OH",
"license": "35-049421",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0903437",
"state": "OH"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "rogerpeckham@uhps.allscriptsdirect.net",
"affiliation": "N",
"address_1": "29101 Health Campus Dr Bldg 2",
"address_2": "SUITE 295",
"city": "Westlake",
"state": "OH",
"country_code": "US",
"postal_code": "441455270",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Westlake, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.