Jeffrey Frank Peacock, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

1084990 Issued in TN

Practice address

650 Joel Dr
Ft. Campbell, Ky
Fort Campbell, KY 42223-5318

Phone

(270) 798-8106

Fax

(279) 956-0180

NPI assigned

Sep 30, 2008

Sex

Male

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

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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

• Murphy Medical Center Inc

  • Certified Registered Nurse Anesthetist
  • Murphy, NC
  • NPI 1649378423
  Medicare reassignment
• Murphy Medical Center, Inc.

  dba Murphy Group Practice

  • Surgery Physician
  • Murphy, NC
  • NPI 1700053865
  NPD
• Murphy Medical Center, Inc.

  dba Erlanger Andrews Family Practice

  • Rural Health Clinic/Center
  • Andrews, NC
  • NPI 1972123537
  NPD

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

{
    "created_epoch": "1222732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222732800000",
    "number": "1972753689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 JOEL DR",
            "address_2": "FT. CAMPBELL BACH",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "422235318",
            "telephone_number": "270-798-8106",
            "fax_number": "279-956-0180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 JOEL DR",
            "address_2": "FT. CAMPBELL, KY",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "422235318",
            "telephone_number": "270-798-8106",
            "fax_number": "279-956-0180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEACOCK",
        "first_name": "JEFFREY",
        "middle_name": "FRANK",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-30",
        "last_updated": "2008-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "1084990",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TN",
            "license": "1084990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dhruvkumar Patel, MD
• Anthony W Patterson, O.D.
• David N Patterson, PHARM.D., BCPS
• Vickie A Patton-Currie, PA-C
• Kristin Mullins Patton, MCD, CCC-SLP
• Samuel M Peik, M.D.
• Bradley Pendley
• Lucas Pepper, DMD
• Cynthia Perry, DO
• Nicholas Peters, ATC, AT, M.ED

• Medical Physician Assistant in Fort Campbell, KY
• Providers in Fort Campbell, KY by specialty
• Medical Physician Assistant in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2008; 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.