MICHAEL SCOTT PECK (NPI# 1770712424) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770712424 |
| Entity Type | Individual |
| Full Name | MICHAEL SCOTT PECK |
| Credential | DPM |
| Practice Address |
1155 Kelly Johnson Blvd #310 Colorado Springs CO 80920-3932 |
| Practice Telephone | 7195749800 |
| Mailing Telephone | 7195749800 |
| Enumeration Date | 2009-07-02 |
| Last Update Date | 2020-02-20 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | POD.0000777 | CO | Podiatric Medicine & Surgery Service Providers |
| N | 213E00000X | Podiatrist | 251 | AR | Podiatric Medicine & Surgery Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477637130 | Michael Stephan Peck | Chiropractor | 660 W 7th St, San Pedro, CA 90731-3118 | 2006-10-25 |
| 1023026176 | Michael Lloyd Peck | Optometrist | 517 W Maine Ave, Enid, OK 73701-5542 | 2006-08-04 |
| 1881629806 | Michael J Peck | Chiropractor | 1530 Avenue O, Huntsville, TX 77340-4452 | 2006-07-11 |
| 1477193597 | Michael Andrew Peck | Case Manager/Care Coordinator | 1724 S Main St, Salt Lake City, UT 84115-1912 | 2020-01-07 |
| 1265825988 | Michael Lawrence Peck | Nurse Practitioner | 5301 E Grant Rd, Tucson, AZ 85712-2805 | 2015-03-05 |
| 1861823353 | Michael Peck | Counselor | 122 1st St, Chestertown, MD 21620-1983 | 2013-12-09 |
| 1881801017 | Michael Wayne Peck | Specialist/Technologist | 2240 Winrow Rd, Fort Huachuca, AZ 85613-5080 | 2007-05-17 |
| 1255543146 | Michael A. Peck | Dentist | 5038 Tennyson Pkwy, Suite A, Plano, TX 75024-2954 | 2007-05-04 |
| 1740328491 | Michael L Peck | Psychologist | 10642 Santa Monica Blvd, Los Angeles, CA 90025-4525 | 2007-02-02 |
| 1336210806 | Michael Peck | Specialist | 1130 Eagle Rock Rd, Colorado Springs, CO 80918-3906 | 2006-11-13 |
| Street Address |
1155 KELLY JOHNSON BLVD #310 |
| City | COLORADO SPRINGS |
| State | CO |
| Zip Code | 80920-3932 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366427825 | Bruce John Zimmerman | Dentist | 1155 Kelly Johnson Blvd, Suite 210, Colorado Springs, CO 80920-3932 | 2005-12-07 |
| 1922565480 | Alicia Vashti Jacobson | Behavior Technician | 1155 Kelly Johnson Blvd, Colorado Springs, CO 80920-3932 | 2019-02-20 |
| 1538659784 | Janessa Ybarra | Behavior Technician | 1155 Kelly Johnson Blvd, Colorado Springs, CO 80920-3932 | 2018-05-14 |
| 1215443619 | Lynn M Gilbert | Behavior Technician | 1155 Kelly Johnson Blvd, Colorado Springs, CO 80920-3932 | 2017-12-20 |
| 1790219947 | Shirlane Diane Winburn | Behavioral Analyst | 1155 Kelly Johnson Blvd, Ste 150, Colorado Springs, CO 80920-3932 | 2017-04-14 |
| 1346787181 | Shadow Mountain Recovery | Clinic/Center | 1155 Kelly Johnson Blvd, Colorado Springs, CO 80920-3932 | 2017-01-31 |
| 1881131852 | Mustard Seed Healthcare Consulting, LLC | Ambulance | 1155 Kelly Johnson Blvd, Suite 111, Colorado Springs, CO 80920-3932 | 2017-01-27 |
| 1245682053 | Joy Warrington | Behavioral Analyst | 1155 Kelly Johnson Blvd, 150, Colorado Springs, CO 80920-3932 | 2016-07-05 |
| 1275997256 | Caitlyn Canfield | Behavioral Analyst | 1155 Kelly Johnson Blvd, 150, Colorado Springs, CO 80920-3932 | 2016-04-06 |
| 1184081663 | Paula Adams Adams | Behavioral Analyst | 1155 Kelly Johnson Blvd, Colorado Springs, CO 80920-3932 | 2016-01-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407463409 | Cynthia Cruz | Marriage & Family Therapist | 7710 N. Union, Ste 100b and 100c, Colorado Springs, CO 80920 | 2020-09-24 |
| 1851905178 | Emergency Medical Specialists, PC | Emergency Medicine | Woodmen Fsed - Md, 3790 E. Woodmen Road, Colorado Springs, CO 80920 | 2020-09-03 |
| 1114531431 | Emergency Medical Specialists, PC | Emergency Medicine | Memorial Hospital North - Md, 4050 Briargate Pkway, Colorado Springs, CO 80920 | 2020-09-03 |
| 1205440583 | Emergency Medical Specialists, PC | Emergency Medicine | Memorial Hospital North - App, 4050 Briargate Pkway, Colorado Springs, CO 80920 | 2020-09-03 |
| 1700490455 | Poudre Valley Medical Group, LLC | Radiology | 4080 Briargate Parkway, Colorado Springs, CO 80920 | 2020-09-01 |
| 1962015792 | Emergency Medical Specialists, PC | Emergency Medicine | Woodmen Fsed - App, 3790 E. Woodmen Road, Colorado Springs, CO 80920 | 2020-08-31 |
| 1194296491 | Kramer Dentistry Inc | Clinic/Center | 9290 Highland Ridge Heights Suite # 120, Colorado Springs, CO 80920 | 2018-12-12 |
| 1134602279 | Juliana Plucinik | Assistant Behavior Analyst | 7011 Campus Drive Suite 205, Colorado Springs, CO 80920 | 2018-09-14 |
| 1811473861 | Vsb Colorado Providers Pllc | Dentist | 1750 Telstar Drive, Suite 200, Colorado Springs, CO 80920 | 2018-07-12 |
| 1336637438 | Children's Hospital Colorado | General Acute Care Hospital | 4090 Briargate Parkway, Colorado Springs, CO 80920 | 2018-04-25 |
| Find all providers in zip 80920 | ||||
| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376606392 | Kenneth N Coates | Podiatrist | 1512 N Union Blvd, Suite 100, Colorado Springs, CO 80909-2810 | 2006-12-19 |
| 1861411225 | Judson T Davis | Podiatrist | 1955 Dominion Way, Suite 130, Colorado Springs, CO 80918-1480 | 2006-07-18 |
| 1568455061 | Gerald Richard Travers | Podiatrist | 1612 E Pikes Peak Ave, Colorado Springs, CO 80909-5619 | 2005-08-30 |
| 1831181536 | Jeremy A Mcvay | Podiatrist | 8580 Scarborough Dr Ste 120, Colorado Springs, CO 80920-7583 | 2005-08-18 |
| 1184616278 | John Robert Swenson | Podiatrist | 2287 Rocking Horse Ct, Colorado Springs, CO 80921-6401 | 2005-08-16 |
| 1427058155 | Stanton Clair Southward | Podiatrist | 1900 E Pikes Peak Ave, Suite 4, Colorado Springs, CO 80909-5850 | 2005-07-22 |
| 1831196815 | Kerry Elizebeth Berg | Podiatrist | 9348 Grand Cordera Pkwy Ste 210, Colorado Springs, CO 80924 | 2005-07-05 |
| 1659984003 | Poudre Valley Medical Group, LLC | Podiatrist | 1400 E Boulder St Ste 600, Colorado Springs, CO 80909-5533 | 2020-08-26 |
| 1316467459 | Maya Christie Trueman | Podiatrist | 455 E Pikes Peak Ave Ste 220, Colorado Springs, CO 80903-3673 | 2017-06-20 |
| 1003050899 | Matthew Diehl Hinderland | Podiatrist | 1465 Kelly Johnson Blvd Ste 100, Colorado Springs, CO 80920-3945 | 2009-04-24 |
| Find all providers in COLORADO SPRINGS | ||||
| City | COLORADO SPRINGS |
| Zip Code | 80920 |
Please comment or provide details below to improve the information on MICHAEL SCOTT PECK.
| 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.