Wendy Marie Peacock, RN

Primary specialty

Ambulatory Care Registered NurseTaxonomy code 163WP2201X

License

2006021691 Issued in MO

Practice address

17145 Lensman Rd
Saint Robert, MO 65584-8612

Phone

(573) 855-5331

NPI assigned

Apr 14, 2011

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

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1302739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302739200000",
    "number": "1942590666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17145 LENSMAN RD",
            "city": "SAINT ROBERT",
            "state": "MO",
            "postal_code": "655848612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17145 LENSMAN RD",
            "city": "SAINT ROBERT",
            "state": "MO",
            "postal_code": "655848612",
            "telephone_number": "573-855-5331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEACOCK",
        "first_name": "WENDY",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-14",
        "last_updated": "2011-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP2201X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Ambulatory Care",
            "state": "MO",
            "license": "2006021691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Open Arms Home Healthcare LLC
• Cassandra Ortegon
• Tamera Palmer
• Mindy Ann Parker, RDH
• Grant Paterson, DO
• Mindi Peay
• Renee Chanelle Peerless, MSW, PLCSW
• Quetzalli Penaloza, COTA
• Xena A Pennington
• Leah P Piatt, PHARMD

• Ambulatory Care Registered Nurse in Saint Robert, MO
• Providers in Saint Robert, MO by specialty
• Ambulatory Care Registered Nurse in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2011; 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.