Active NPI
Leah Peacock, CNM
- Obstetrics & Gynecology Nurse Practitioner
- Marietta, GA
National Provider Identifier
1922400514
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Nurse Practitioner
- License
- ARNP9204747
- Practice address
- 699 Church St NE
Suite 300
Marietta, GA 30060-1110 - Phone
- (770) 422-8700
- NPI assigned
- Sep 25, 2014
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Obstetrics & Gynecology Nurse Practitioner | 363LX0001X | ARNP9204747 | FL | Primary |
Addresses
Primary practice location
699 Church St NE
Suite 300
Marietta, GA 30060-1110
Mailing address
699 Church St NE
Suite 300
Marietta, GA 30060-1110
Medicare participation
Medicare enrollment files- 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: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Oct 3, 2017 through Oct 3, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Midwife
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ARNP9204747 | FL | MD | Obstetrics & Gynecology Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1411603200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1412812800000",
"number": "1922400514",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "699 CHURCH ST NE",
"address_2": "SUITE 300",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300601110"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "699 CHURCH ST NE",
"address_2": "SUITE 300",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300601110",
"telephone_number": "770-422-8700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEACOCK",
"first_name": "LEAH",
"credential": "CNM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-09-25",
"last_updated": "2014-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "363LX0001X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Obstetrics & Gynecology",
"state": "FL",
"license": "ARNP9204747",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marietta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.