NPIMap

Individual provider Active NPI

Kimberly Carter Peck, M.D.

  • Internal Medicine Physician
  • Camden, NC
National Provider Identifier
1952375438
Registry record updated Mar 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
200100521 Issued in NC
Practice address
100 Plank Bridge Rd CT Unit B
Camden, NC 27921-7027
Phone
(252) 331-1829
NPI assigned
Feb 14, 2006
Last updated
Mar 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 200100521 NC Primary
Rheumatology Physician 207RR0500X 200100521 NC

Addresses

Primary practice location

100 Plank Bridge Rd CT Unit B
Camden, NC 27921-7027

Mailing address

667 Kingsborough SQ Ste 101
Chesapeake, VA 23320-4999

Other practice location 1

1134 N Road St Ste 4
Elizabeth City, NC 27909-3365
Phone (252) 338-4117

Other identifiers 1

IdentifierTypeStateIssuer
89129T7MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, VA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100913000340 NC Practitioner - RheumatologyPractitioner - Internal Medicine 9739077298 Reassigns benefits to 2 organizations
I20250318003553 VA Practitioner - Internal Medicine 9739077298 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
RheumatologyAlso: Internal Medicine
Education
Virginia Commonwealth University, School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chesapeake Regional Medical GroupGroup PAC ID 8426113663, 148 clinicians

Practice addresses (Care Compare)

534 Caratoke Hwy
Moyock, NC 27958-8740
Phone (252) 435-6621

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
32.16 of 100Reported as individual
Quality
15
Improvement activities
0
Cost
87.2

Merit-based Incentive Payment System (MIPS)

Final score
90.57 of 100Reported as group
Quality
87.01
Promoting interoperability
100
Improvement activities
40
Cost
81.57

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Chesapeake Regional Medical Group CurrentSince Dec 6, 2023 Accepting new patients
Tarheel Internal Medicine Associates Inc. CurrentSince Jul 23, 2001 Accepting new patients
Chesapeake Regional Medical Group CurrentSince Nov 8, 2024 Accepting new patients
Chesapeake Regional Medical Group Internal Medicine CurrentSince Dec 6, 2023 Accepting new patients

Locations

100 Plank Bridge Rd Ct
Unit B
Camden, NC 27921
Phone (252) 331-1829

102 Medical Dr
Elizabeth Cty, NC 27909
Phone (252) 338-4117

1134 N Road St
Ste 4
Elizabeth Cty, NC 27909
Phone (252) 338-4117

534 Caratoke Hwy
Moyock, NC 27958
Phone (252) 435-6621

300 Medical Pkwy
Chesapeake, VA 23320
Phone (757) 312-6102

667 Kingsborough Sq
Ste 101
Chesapeake, VA 23320
Phone (757) 312-3132

Interoperability endpoints

  • Direct secure messaging: kimberly.cerveny.1@5072.direct.athenahealth.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710806400000",
    "number": "1952375438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "667 KINGSBOROUGH SQ STE 101",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233204999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PLANK BRIDGE RD CT UNIT B",
            "city": "CAMDEN",
            "state": "NC",
            "postal_code": "279217027",
            "telephone_number": "252-331-1829"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1134 N Road St Ste 4",
            "address_purpose": "LOCATION",
            "city": "Elizabeth City",
            "state": "NC",
            "postal_code": "279093365",
            "country_code": "US",
            "telephone_number": "252-338-4117",
            "fax_number": "252-338-2087",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PECK",
        "first_name": "KIMBERLY",
        "middle_name": "CARTER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-14",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "200100521",
            "primary": true
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "NC",
            "license": "200100521",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89129T7",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Camden, NC

Sources for this page

Verify at the official NPI Registry.