CARLIE LAYNE PEACOCK (NPI# 1407382864) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407382864 |
| Entity Type | Individual |
| Full Name | CARLIE LAYNE PEACOCK |
| Credential | NP |
| Practice Address |
2055 E South Blvd Ste 601 Montgomery AL 36116-2014 |
| Mailing Address |
301 Brown Springs Rd Montgomery AL 36117-7005 |
| Practice Telephone | 3342819000 |
| Practice Fax Number | 3342818262 |
| Mailing Telephone | 3342734159 |
| Mailing Fax Number | 3342734556 |
| Enumeration Date | 2017-05-04 |
| Last Update Date | 2018-10-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 1-137124 | AL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | 212224 | 05 | |
| AL | BCBS OF ALABAMA | 512-04312 | 01 |
| AL | BCBS OF ALABAMA | 512-04310 | 01 |
| AL | MEDICARE | A0001K874 | 01 |
| AL | VIVA HEALTH | Z54221 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 645 Mcqueen Smith Rd N Ste 300, Prattville, AL 360667269 | 3342862999 | 3346137276 |
| Street Address |
2055 E SOUTH BLVD STE 601 |
| City | MONTGOMERY |
| State | AL |
| Zip Code | 36116-2014 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902150089 | John Ryan Aldridge | Nurse Practitioner | 2055 E South Blvd Ste 601, Montgomery, AL 36116-2014 | 2012-10-29 |
| 1871912139 | Benton Cason | Surgery | 2055 E South Blvd Ste 601, Montgomery, AL 36116-2014 | 2014-04-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275153892 | Sayyeda Ann Uz Zahra | Student in an Organized Health Care Education/Training Program | 2055 East South Blvd. Suite 202, Uab Montgomery, Montgomery, AL 36116 | 2020-04-23 |
| 1861958241 | Tameka Lene' Myles | Nurse Practitioner | 2905 East South Boulevard, Montgomery, AL 36116 | 2019-02-11 |
| 1750869814 | Nina Yvette Massey | Family Medicine | Baptist South Uab Multi Specialty Clinic, 2119 E. South Blvd, Montgomery, AL 36116 | 2018-08-01 |
| 1336635697 | Briana Lynn Adair | Speech-Language Pathologist | 2185 Normandie Rd., Montgomery, AL 36116 | 2018-07-10 |
| 1790201770 | Rinka Ravi Pahwani | Student in an Organized Health Care Education/Training Program | 4371 Narrow Lane Road, Suite 100, Montgomery, AL 36116 | 2017-08-21 |
| 1982052015 | Kevin J Jones | Pharmacist | 4385 Narrow Lane Rd, Montgomery, AL 36116 | 2016-05-31 |
| 1891153284 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 8035 Vaughn Road, Montgomery, AL 36116 | 2016-02-01 |
| 1871917583 | E Dental | Dentist | 6956 Vaughn Rd, Montgomery, AL 36116 | 2014-02-17 |
| 1033545199 | Jennings Professional Services LLC | Home Health | 2921 Martin Lane, Montgomery, AL 36116 | 2013-09-20 |
| 1750721973 | Joseph Alan Taylor | Counselor | 8104 Seaton Place, Montgomery, AL 36116 | 2013-07-02 |
| Find all providers in zip 36116 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326528696 | Agnes Oberkor | Nurse Practitioner | 201 Monroe St Ste 1440, Montgomery, AL 36104-3704 | 2018-08-16 |
| 1720503287 | Kimberly Ann Corona | Nurse Practitioner | 488 St. Lukes Dr., Montgomery, AL 36117 | 2017-08-07 |
| 1720537335 | Cynthia Renne' Barrett | Nurse Practitioner | 1231 Perry Hill Road, Suite C, Montgomery, AL 36109 | 2016-09-23 |
| 1568895589 | Amanda Dease Hargrove | Nurse Practitioner | 2065 E South Blvd Ste 401, Montgomery, AL 36116-2462 | 2013-08-13 |
| 1053750315 | Janet Marie Reed | Nurse Practitioner | 1758 Park Pl Ste 100, Montgomery, AL 36106-1133 | 2013-06-20 |
| 1215285879 | Lindsey T Barton | Nurse Practitioner | 7461 East Drive, Ste 102, Montgomery, AL 36117-2714 | 2012-08-29 |
| 1194043141 | Julie Pavach | Nurse Practitioner | 10506a Montgomery Rd, Montgomery, OH 45242-4402 | 2010-05-13 |
| 1740467745 | Megan Leigh Strickland | Nurse Practitioner | 114 Mitylene Park Ln, Montgomery, AL 36117-3758 | 2008-01-22 |
| 1427065630 | Dianne Kay Wills | Nurse Practitioner | 2105 East South Boulevard, Attn; Palliative Care, Montgomery, AL 36116-2509 | 2006-08-01 |
| 1962434027 | Steven E Cox | Nurse Practitioner | 700 Hyundai Blvd, Montgomery, AL 36105-9622 | 2006-07-07 |
| Find all providers in MONTGOMERY | ||||
| City | MONTGOMERY |
| Zip Code | 36116 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.