Peacock Foot Clinic, PC

Primary specialty

Foot Surgery PodiatristTaxonomy code 213ES0131X

License

382 Issued in NC

Legal business name

PEACOCK FOOT CLINIC, PC

Practice address

409 Williams St
Elizabethtown, NC 28337

Phone

(910) 642-7768

Fax

(910) 642-6541

NPI assigned

Nov 5, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Don Peacock, DPM

Title

President

Phone

(910) 642-7768

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kerry Allyson Smith, DPM

  • Foot Surgery Podiatrist
  • Wilmington, NC
  • NPI 1598834350
  NPD (past)

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

{
    "created_epoch": "1225843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225843200000",
    "number": "1982858874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 JEFFERSON ST",
            "city": "WHITEVILLE",
            "state": "NC",
            "postal_code": "284723601",
            "telephone_number": "910-642-7755",
            "fax_number": "910-642-6541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 WILLIAMS ST",
            "city": "ELIZABETHTOWN",
            "state": "NC",
            "postal_code": "28337",
            "telephone_number": "910-642-7768",
            "fax_number": "910-642-6541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACOCK FOOT CLINIC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-05",
        "last_updated": "2008-11-05",
        "status": "A",
        "authorized_official_last_name": "PEACOCK",
        "authorized_official_first_name": "DON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "910-642-7768",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": "NC",
            "license": "382",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8908003",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Foot Surgery Podiatrist in Elizabethtown, NC
• Providers in Elizabethtown, NC by specialty
• Foot Surgery Podiatrist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2008; 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.