REBECCA ANN PECK (NPI# 1063518991) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063518991 |
| Entity Type | Individual |
| Full Name | REBECCA ANN PECK |
| Credential | MD |
| Practice Address |
305 Memorial Medical Pkwy Ste 401 Daytona Beach FL 32117-5169 |
| Practice Telephone | 3862313612 |
| Practice Fax Number | 3862313613 |
| Mailing Telephone | 3862313612 |
| Mailing Fax Number | 3862313613 |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2019-11-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | ME79132 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 261428600 | 05 | |
| FL | RAILROAD MEDICARE | P00024189 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477081982 | Rebecca Jeanne Peck | Speech-Language Pathologist | 2540 Billingsley Rd, Columbus, OH 43235-1990 | 2017-05-28 |
| 1821423005 | Rebecca Peck | Student in an Organized Health Care Education/Training Program | 456 Elm Ave., Long Beach, CA 90802 | 2013-09-06 |
| 1164446985 | Rebecca Davis Peck | Specialist | 3009 N Ballas Rd, Ste. 208b, Saint Louis, MO 63131-2322 | 2006-07-26 |
| 1639104045 | Rebecca L Peck | Optometrist | 425 So 2nd St, Midwest Vision Clinic Plc, Clinton, IA 52732 | 2006-07-12 |
| Street Address |
305 MEMORIAL MEDICAL PKWY STE 401 |
| City | DAYTONA BEACH |
| State | FL |
| Zip Code | 32117-5169 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841396769 | Benjamin J Peck | Family Medicine | 305 Memorial Medical Pkwy Ste 401, Daytona Beach, FL 32117-5169 | 2006-09-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992350409 | Erin Selfridge | Pharmacist | 1500 Beville Rd #300, Daytona Beach, FL 32117 | 2019-08-02 |
| 1881185494 | Wellspring Health, LLC | Chiropractor | 701 Ridgewood Ave, Holly Hills, FL 32117 | 2018-05-21 |
| 1780172791 | L & L Db, LLC | Clinic/Center | 1540 Cornerstone Blvd, Suite 100, Daytona Beach, FL 32117 | 2018-04-25 |
| 1154837789 | Brittany Nikolow | Nurse Practitioner | 1717 N. Clyde Morris, Daytona Beach, FL 32117 | 2017-12-19 |
| 1205356946 | Alejandro Andre Pabon Rodriguez | Nurse Anesthetist, Certified Registered | Florida Hospital Memorial Medical Center, 301 Memorial Medical Parkway, Daytona Beach, FL 32117 | 2017-06-23 |
| 1316492135 | Ann Van Herck | Physical Therapist | 1901 Mason Ave Ste 105, Daytona Beach, FL 32117 | 2016-08-22 |
| 1952784779 | Kathryn Brenna Copley | Nurse Practitioner | 1890 Lpga Blvd., Daytona Beach, FL 32117 | 2015-06-30 |
| 1053719559 | Alicia Graham | Case Manager/Care Coordinator | 1570 Megan Bay Circle, Holly Hill, FL 32117 | 2014-12-15 |
| 1578974440 | Halifax Senior Care Inc | Clinic/Center | 1515 Ridgewood Ave, Suite B, Holly Hill, FL 32117 | 2014-05-14 |
| 1013345883 | Kist Alf, Inc | Assisted Living Facility | 1516 Carmen Avenue, Daytona Beach, FL 32117 | 2013-10-14 |
| Find all providers in zip 32117 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164063178 | Jordann Wood | Family Medicine | 1890 Lpga Blvd Ste 140, Daytona Beach, FL 32117-7131 | 2019-10-01 |
| 1154806933 | Steve Anthony Lee | Family Medicine | 731 N. Clyde Morris Blvd, Daytona Beach, FL 32114 | 2018-09-27 |
| 1104347053 | Harry Herman Blanke IIi | Family Medicine | 201 N Clyde Morris Blvd, Suite 200, Halifax Health Family Medicine Residency Program, Daytona Beach, FL 32114 | 2017-06-30 |
| 1245636042 | Dr Ejaz Ahmed Md Pa | Family Medicine | 405 North Clyde Morris Blvd, Daytona Beach, FL 32114-2730 | 2014-11-06 |
| 1063703833 | Brittany O'dwyer Newton | Family Medicine | 201 N Clyde Morris Blvd Ste 210, Daytona Beach, FL 32114-2765 | 2011-04-27 |
| 1548498561 | Ayodeji Ladele | Family Medicine | 1410 Lpga Blvd Ste 136, Daytona Beach, FL 32117-5146 | 2009-06-29 |
| 1417182932 | Phillip Michael Mele Jr. | Family Medicine | 331 Williams Ave, Daytona Beach, FL 32118-3339 | 2009-05-28 |
| 1326280991 | Kevin Anthony Johnson | Family Medicine | 1400 Hancock Blvd, #1208, Daytona Beach, FL 32114 | 2009-03-29 |
| 1265658744 | Jessika Gil-pineda | Family Medicine | 1300 Red John Dr, Daytona Beach, FL 32124-1075 | 2007-04-17 |
| 1548381049 | Andrew Jonathan Niewald | Family Medicine | 305 Memorial Medical Pkwy Ste 502, Daytona Beach, FL 32117-5169 | 2007-04-02 |
| Find all providers in DAYTONA BEACH | ||||
| City | DAYTONA BEACH |
| Zip Code | 32117 |
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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.