Carol I Peake LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

License

177151 Issued in OH

Legal business name

CAROL I PEAKE LLC

Practice address

5830 Woodrow Dr
Sylvania, OH 43560-1245

Phone

(419) 488-2089

NPI assigned

Oct 20, 2010

Organization subpart

No

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

Authorized official

Name

Mrs. Carol I. Peake, NP-C

Title

FNP

Phone

41948810890

Specialties & licenses 5

Addresses

Other identifiers 4

Other names 1

• Peake Care Doing business as

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

{
    "created_epoch": "1287532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1290211200000",
    "number": "1992015135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5830 WOODROW DR",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435601245",
            "telephone_number": "419-488-2089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5830 WOODROW DR",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435601245",
            "telephone_number": "419-488-2089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROL I PEAKE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-20",
        "last_updated": "2010-11-20",
        "status": "A",
        "authorized_official_last_name": "PEAKE",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "I.",
        "authorized_official_title_or_position": "FNP",
        "authorized_official_telephone_number": "41948810890",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "NP-C"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "OH",
            "license": "177151",
            "primary": true
        },
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "OH",
            "license": "2127186",
            "primary": false
        },
        {
            "code": "276400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation, Substance Use Disorder Unit",
            "state": "OH",
            "license": "177151",
            "primary": false
        },
        {
            "code": "281P00000X",
            "taxonomy_group": "",
            "desc": "Chronic Disease Hospital",
            "state": "OH",
            "license": "1467635664",
            "primary": false
        },
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "OH",
            "license": "1992015135",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAROL PEAKE, NP-C",
            "identifier": "4704194858",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAROL PEAKE, RN, BSN",
            "identifier": "177151",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAROL PEAKE, BSN",
            "identifier": "2127186",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAROL PEAKE, NP-C",
            "identifier": "4704194858",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Peake Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Multi-Specialty Clinic/Center in Sylvania, OH
• Providers in Sylvania, OH by specialty
• Multi-Specialty Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2010; 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.