AMANDA PEACOCK (NPI# 1740732924) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740732924 |
| Entity Type | Individual |
| Full Name | AMANDA PEACOCK |
| Credential | CSFA |
| Practice Address |
1200 Evergreen Cir Eastman GA 31023-3568 |
| Practice Telephone | 4782312241 |
| Mailing Telephone | 4782312241 |
| Enumeration Date | 2016-11-03 |
| Last Update Date | 2018-01-17 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831300334 | Amanda B. Peacock | Social Worker | 21 Pequossette St, Watertown, MA 02472-2761 | 2007-05-25 |
| 1437627098 | Amanda E Peacock | Case Manager/Care Coordinator | 1544 Elmira St, Aurora, CO 80010-2116 | 2018-11-12 |
| 1669721155 | Amanda B Peacock | Nurse Practitioner | 3 Shircliff Way, Suite 714, Jacksonville, FL 32204-4757 | 2012-08-30 |
| 1134406184 | Amanda Dawn Peacock | Nurse Practitioner | 368 Fell St, San Francisco, CA 94102-5144 | 2011-11-04 |
| Street Address |
1200 EVERGREEN CIR |
| City | EASTMAN |
| State | GA |
| Zip Code | 31023-3568 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821555913 | Community Service Board of Middle Georgia | Day Training, Developmentally Disabled Services | 1444 Morgan Creek Dr, Eastman, GA 31023 | 2019-02-25 |
| 1174832232 | Lynetta Davies | Counselor | 17 Tanner Dr, Eastmon, GA 31023 | 2010-10-06 |
| 1467774380 | Dustin Phillip Smith | Chiropractor | 285 Plaza Avenue, Eastman, GA 31023 | 2010-02-19 |
| 1639311145 | D&b Home Care Inc | Durable Medical Equipment & Medical Supplies | 714 Medical Center Drive, Eastman, GA 31023 | 2009-03-30 |
| 1427273465 | Hospice Care Options Inc | Hospice Care, Community Based | 715 Legion Dr, Eastman, GA 31023 | 2007-04-16 |
| 1740318625 | Dana W Mullis | Dentist | 1003 Plaza Ave, Eastman, GA 31023 | 2007-03-01 |
| 1285787630 | 801 Legion LLC | Skilled Nursing Facility | 815 Legion Dr, Eastman, GA 31023 | 2007-01-19 |
| 1396813317 | Womens Health PC | Obstetrics & Gynecology | 821 Plaza Ave, Suite B, Eastman, GA 31023 | 2006-11-30 |
| 1932294170 | John D Roberts | Ophthalmology | 917 Plaza Avenue, Eastman, GA 31023 | 2006-10-04 |
| 1215030978 | Georgia Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 535 Oak St, Eastman, GA 31023 | 2006-09-07 |
| Find all providers in zip 31023 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336748409 | Jesse Aaron Denson | Physician Assistant | 2046 Point Grey Ct Nw, Kennesaw, GA 30152-8276 | 2020-10-20 |
| 1568074227 | James D Craig | Physician Assistant | 3210 New College Way, Cumming, GA 30041-2896 | 2020-08-23 |
| 1982223244 | Keith Hawkins | Physician Assistant | 8498 Glenview St, Douglasville, GA 30134-5639 | 2020-04-15 |
| 1639704307 | Spectrum Surgical LLC | Physician Assistant | 3142 Highway 278 Nw # 135, Covington, GA 30014-2304 | 2020-03-03 |
| 1255962205 | Songthu Nguyen | Physician Assistant | 6119 Foxcroft Ct, Morrow, GA 30260-1069 | 2020-01-29 |
| 1265071229 | Stellar Surgical Assisting | Physician Assistant | 3446 Winder Hwy Ste M-322, Flowery Branch, GA 30542-3007 | 2019-12-22 |
| 1194363366 | Clara A Matthews | Physician Assistant | 1930 Windsor Creek Drive Sw, Conyers, GA 30094 | 2019-12-18 |
| 1922640739 | Jeremiah George Blair | Physician Assistant | 61 Whitcher St Suite 2100, Marietta, GA 30060 | 2019-10-14 |
| 1710528401 | Hannah Ingrid Boomgarden | Physician Assistant | 1467 Harper Street Hb 5040, Augusta, GA 30912-5775 | 2019-10-03 |
| 1891257028 | Symmetry Surgical Billing LLC | Physician Assistant | 5135 Mirror Lake Dr, Cumming, GA 30028-7216 | 2019-04-05 |
| Find all providers with the same taxonomy | ||||
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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.