Henry Navarre Peabody IV, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

5151016835 Issued in MI

Practice address

1202 W Oak St Ste 5100
Greenville, MI 48838-2155

Phone

(616) 267-7668

Fax

(616) 754-9883

NPI assigned

Apr 8, 2024

Last updated

Jun 21, 2024By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

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

{
    "created_epoch": "1712534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718928000000",
    "number": "1932952389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 W OAK ST STE 5100",
            "city": "GREENVILLE",
            "state": "MI",
            "postal_code": "488382155",
            "telephone_number": "616-267-7668",
            "fax_number": "616-754-9883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 W OAK ST STE 5100",
            "city": "GREENVILLE",
            "state": "MI",
            "postal_code": "488382155",
            "telephone_number": "616-267-7668",
            "fax_number": "616-754-9883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEABODY",
        "first_name": "HENRY",
        "middle_name": "NAVARRE",
        "name_suffix": "IV",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-08",
        "last_updated": "2024-06-21",
        "certification_date": "2024-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5151016835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gregory Raymond Page, MD
• Florence Amy Parker-Tunnell
• Jan Parmenter
• Partners in Pain and Spine PLC
• Calli Marie Peabody, LMSW
• Susan Clair Perdue, BS
• Jennifer L Peterman, RD
• Amanda Jo Peterson, LLPC
• Nicolas M. Piechotte, LMSW
• Pavel Pilar, MD

• Family Medicine Physician in Greenville, MI
• Providers in Greenville, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2024; 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.