Corey A Peacock, OT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT- 418 Issued in HI

Practice address

95-390 Kuahelani Ave
1C
Mililani, HI 96789-1192

Phone

(808) 445-4428

Fax

(866) 637-9592

NPI assigned

Nov 8, 2005

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1131408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616457600000",
    "number": "1942281969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59-520 HOALIKE RD",
            "city": "HALEIWA",
            "state": "HI",
            "postal_code": "967129525",
            "telephone_number": "808-371-5460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95-390 KUAHELANI AVE",
            "address_2": "1C",
            "city": "MILILANI",
            "state": "HI",
            "postal_code": "967891192",
            "telephone_number": "808-445-4428",
            "fax_number": "866-637-9592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEACOCK",
        "first_name": "COREY",
        "middle_name": "A",
        "name_prefix": "Miss",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-08",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "HI",
            "license": "OT-418",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "HI",
            "license": "OT- 418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gail Patingan
• Winnie Elizabeth Paul, P.A.
• Judynes Paulo
• Savannah Paulo
• Melanie Moanikeala Payanal, M.D.
• Shannon Peahi-Ching
• Julia Michelle Perez Jensen
• Chana Perkin
• Lavon L Petersen, LCSW
• Tiana Peterson

• Occupational Therapist in Mililani, HI
• Providers in Mililani, HI by specialty
• Occupational Therapist in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.