MR. JEFFREY FRANK PEACOCK (NPI# 1972753689) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972753689 |
| Entity Type | Individual |
| Full Name | MR. JEFFREY FRANK PEACOCK |
| Credential | PA-C |
| Practice Address |
650 Joel Dr Ft. Campbell, Ky Fort Campbell KY 42223-5318 |
| Mailing Address |
650 Joel Dr Ft. Campbell Bach Fort Campbell KY 42223-5318 |
| Practice Telephone | 2707988106 |
| Practice Fax Number | 2799560180 |
| Mailing Telephone | 2707988106 |
| Mailing Fax Number | 2799560180 |
| Enumeration Date | 2008-09-30 |
| Last Update Date | 2008-09-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | 1084990 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
1084990 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811158439 | Jeffrey Edward Peacock | Anesthesiology | 50 Miller St Ste I, Winston Salem, NC 27104-4206 | 2008-06-17 |
| 1033566534 | Jeffrey Peacock | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Ave, Orange Park, FL 32073-5148 | 2016-05-16 |
| 1245514629 | Jeffrey Peacock | Acupuncturist | 385 Main St, Unit D, Longmont, CO 80501-5569 | 2011-10-04 |
| Street Address |
650 JOEL DR FT. CAMPBELL, KY |
| City | FORT CAMPBELL |
| State | KY |
| Zip Code | 42223-5318 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982601803 | Carol Lynn Pasewark | Counselor | 650 Joel Dr, Fort Campbell, KY 42223-5318 | 2005-07-07 |
| 1568063519 | Jeremy Schadewald | Physician Assistant | 650 Joel Dr, Fort Campbell, KY 42223-5318 | 2020-11-05 |
| 1578164760 | Brandi Mangan | Nurse Practitioner | 650 Joel Dr, Fort Campbell, KY 42223-5318 | 2020-11-04 |
| 1912506692 | Rose Dunn | Optometrist | 650 Joel Dr, Fort Campbell, KY 42223-5318 | 2020-10-22 |
| 1659989440 | Patrick Ogden | Student in an Organized Health Care Education/Training Program | 650 Joel Dr, Fort Campbell, KY 42223-5318 | 2020-07-17 |
| 1487262408 | John William Zamora | Physician Assistant | 650 Joel Dr, Fort Campbell, KY 42223-5318 | 2020-07-15 |
| 1295343218 | Joshua Ryan Agard | Physician Assistant | 650 Joel Dr, Fort Campbell, KY 42223-5318 | 2020-07-15 |
| 1902424435 | Shaina Escribano-miranda | Nurse Practitioner | 650 Joel Dr, Fort Campbell, KY 42223-5318 | 2020-07-10 |
| 1326665514 | Cristal Lagail Trotter | Nurse Anesthetist, Certified Registered | 650 Joel Dr, Fort Campbell, KY 42223-5318 | 2020-07-03 |
| 1689209728 | William James Bradshaw | Physician Assistant | 650 Joel Dr, Fort Campbell, KY 42223-5318 | 2020-03-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558978825 | Eden Addisu Kebede | Social Worker | Ft. Campbell/bach, 650 Joel Drive, Fort Campbell, KY 42223 | 2020-09-30 |
| 1174134662 | Lucas Pepper | Dentist | Desert Storm Ave, Bldg 5580, Apo, AA 42223 | 2020-08-10 |
| 1639711203 | Travis Robert Bryant | Optometrist | 5979 Desert Storm Ave., Lapointe Health Clnic Optometry, Ft. Campbell, KY 42223 | 2019-10-15 |
| 1184138232 | Vanessa Renee Simmons | Dental Assistant | 302b Baker St, Fort Campbell, KY 42223 | 2017-11-28 |
| 1922451996 | Isabella Julson | Dental Assistant | Bldg2441 21st Street, Us Army Dental Activity, Fort Campbell, KY 42223 | 2016-07-14 |
| 1336595305 | Heidi Cameron | Acupuncturist | 2889b Idaho Avenue, Fort Campbell, KY 42223 | 2016-05-10 |
| 1649644154 | Nathan Silvey | Physician Assistant | Building 4179, Fort Campbell, KY 42223 | 2015-11-20 |
| 1396145306 | Blanchfield Army Community Hospital | Clinic/Center | Bldg 2403, Air Assault St and Indiana Ave, Fort Campbell, KY 42223 | 2014-08-27 |
| 1275948564 | Rodney C Merkley | Psychologist | Building 3929, Ft. Capmbell, KY 42223 | 2014-06-25 |
| 1659785053 | Blanchfield Army Community Hospital | Clinic/Center | Bldg 6747 A Shau Valley Road, Fort Campbell, KY 42223 | 2014-06-13 |
| Find all providers in zip 42223 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720572118 | Robert Farmer | Physician Assistant | 650 Joel Dr, Fort Campbell, KY 42223-5318 | 2018-06-19 |
| 1134675481 | Joseph Flynn Drevlow | Physician Assistant | Blanchfield Army Community Hospital, 650 Joel Drive, Fort Campbell, KY 42223 | 2016-08-28 |
| 1497112866 | Laurencio Lopez | Physician Assistant | 650 Joel Dr, Fort Campbell, KY 42223-5318 | 2016-01-15 |
| 1457716953 | Calvin Albert Rowe IIi | Physician Assistant | 650 Joel Dr, Fort Campbell, KY 42223 | 2015-12-28 |
| 1114201654 | Robert D Blume | Physician Assistant | 650 Joel Dr, Fort Campbell, KY 42223-5318 | 2011-10-03 |
| 1912203464 | Alec E Ross | Physician Assistant | 650 Joel Dr, Fort Campbell, KY 42223-5318 | 2011-02-01 |
| 1669780078 | Kevin E. Mayberry | Physician Assistant | 650 Joel Dr, Fort Campbell, KY 42223-5318 | 2010-09-20 |
| 1437460698 | Beth Ann Shay-stidom | Physician Assistant | 650 Joel Dr, Fort Campbell, KY 42223-5318 | 2010-06-23 |
| 1083864292 | Krista Joy Haith | Physician Assistant | 650 Joel Dr, Credentials Office, Fort Campbell, KY 42223-5318 | 2008-09-24 |
| 1700059052 | Daniel John Hankes | Physician Assistant | 650 Joel Dr, Blanchfield Army Community Hospital, Fort Campbell, KY 42223-5318 | 2008-04-08 |
| Find all providers in FORT CAMPBELL | ||||
| City | FORT CAMPBELL |
| Zip Code | 42223 |
Please comment or provide details below to improve the information on MR. JEFFREY FRANK PEACOCK.
| 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.