NPIMap

Individual provider Active NPI

Brenda Peck

  • Registered Respiratory Therapist
  • Gresham, OR
National Provider Identifier
1982187365
Registry record updated Sep 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered Respiratory TherapistTaxonomy code 227900000X
License
P-000594 Issued in OR
Practice address
1727 SW 4TH St
Gresham, OR 97080-6716
Phone
(503) 449-3804
NPI assigned
Sep 11, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2018

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

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered Respiratory Therapist 2279H0200X LR60450229 WA
Home Health Registered Respiratory Therapist 2279H0200X P-00594 OR
Neonatal/Pediatric Registered Respiratory Therapist 2279P3900X LR60450229 WA
Neonatal/Pediatric Registered Respiratory Therapist 2279P3900X P-000594 OR
Registered Respiratory Therapist 227900000X LR60450229 WA
Patient Transport Registered Respiratory Therapist 2279P4000X P-000594 OR
Patient Transport Registered Respiratory Therapist 2279P4000X LR60450229 WA
Registered Respiratory Therapist 227900000X P-000594 OR Primary

Addresses

Primary practice location

1727 SW 4TH St
Gresham, OR 97080-6716

Mailing address

1727 SW 4TH St
Gresham, OR 97080-6716
Phone (503) 449-3804

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
P-00594ORMDHome Health Registered Respiratory Therapist
P-000594ORMDPatient Transport Registered Respiratory Therapist
LR60450229WAMDPatient Transport Registered Respiratory Therapist

NPI Registry JSON

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

{
    "created_epoch": "1536624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536624000000",
    "number": "1982187365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1727 SW 4TH ST",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970806716",
            "telephone_number": "503-449-3804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1727 SW 4TH ST",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970806716",
            "telephone_number": "503-449-3804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECK",
        "first_name": "BRENDA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-11",
        "last_updated": "2018-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2279H0200X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Registered, Home Health",
            "state": "WA",
            "license": "LR60450229",
            "primary": false
        },
        {
            "code": "2279H0200X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Registered, Home Health",
            "state": "OR",
            "license": "P-00594",
            "primary": false
        },
        {
            "code": "2279P3900X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Registered, Neonatal/Pediatrics",
            "state": "WA",
            "license": "LR60450229",
            "primary": false
        },
        {
            "code": "2279P3900X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Registered, Neonatal/Pediatrics",
            "state": "OR",
            "license": "P-000594",
            "primary": false
        },
        {
            "code": "227900000X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Registered",
            "state": "WA",
            "license": "LR60450229",
            "primary": false
        },
        {
            "code": "2279P4000X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Registered, Patient Transport",
            "state": "OR",
            "license": "P-000594",
            "primary": false
        },
        {
            "code": "2279P4000X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Registered, Patient Transport",
            "state": "WA",
            "license": "LR60450229",
            "primary": false
        },
        {
            "code": "227900000X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Registered",
            "state": "OR",
            "license": "P-000594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gresham, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2018; 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.