RICHARD ANTHONY PECKHAM (NPI# 1174964357) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1174964357 |
Entity Type | Individual |
Full Name | RICHARD ANTHONY PECKHAM |
Other Name | ANTHONY DIRZLER |
Credential | RN |
Practice Address |
3015 Veterans Pkwy S Moultrie GA 31788-6705 |
Mailing Address |
817 Prince Ave Tifton GA 31794-4053 |
Practice Telephone | 2299854815 |
Practice Fax Number | 2298906777 |
Mailing Telephone | 2293762859 |
Enumeration Date | 2013-07-16 |
Last Update Date | 2013-07-16 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
RN162464 | GA | Physician Assistants & Advanced Practice Nursing Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1750373395 | Richard Worth Peckham | Internal Medicine | 715 N College Ave, El Dorado, AR 71730-4403 | 2005-08-19 |
Street Address |
3015 VETERANS PKWY S |
City | MOULTRIE |
State | GA |
Zip Code | 31788-6705 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1205809571 | Turning Point Care Center LLC | Psychiatric Hospital | 3015 Veterans Pkwy S, Moultrie, GA 31788-6705 | 2006-02-08 |
1164050647 | Marsha Tillman Carlton | Social Worker | 3015 Veterans Pkwy S, Moultrie, GA 31788-6705 | 2020-03-30 |
1538647581 | Kelly Suzanne Rychener | Nurse Practitioner | 3015 Veterans Pkwy S, Moultrie, GA 31788-6705 | 2018-08-01 |
1053807420 | Janett Davis | Registered Nurse | 3015 Veterans Pkwy S, Moultrie, GA 31788-6705 | 2018-07-09 |
1255839536 | David Griner | Social Worker | 3015 Veterans Pkwy S, Moultrie, GA 31788-6705 | 2018-02-01 |
1912365271 | Dorothy Stringer | Social Worker | 3015 Veterans Pkwy S, Moultrie, GA 31788-6705 | 2016-02-02 |
1194192492 | Turning Point | Substance Abuse Rehabilitation Facility | 3015 Veterans Pkwy S, Moultrie, GA 31788-6705 | 2015-08-22 |
1801287917 | Alesia R Christian | Social Worker | 3015 Veterans Pkwy S, Moultrie, GA 31788-6705 | 2015-02-11 |
1518357250 | Peggy Yates | Social Worker | 3015 Veterans Pkwy S, Moultrie, GA 31788-6705 | 2015-02-03 |
1558769786 | Laura Mullis | Social Worker | 3015 Veterans Pkwy S, Moultrie, GA 31788-6705 | 2014-12-22 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1295283620 | Convenient Rx LLC | Pharmacy | 640 Veterans Pkwy N, Moultrie, GA 31788 | 2016-09-14 |
1861745994 | Sherry Marie Mccoy | Clinical Nurse Specialist | 3015 Veterans Parkaway, Moultrie, GA 31788 | 2012-10-26 |
1083874895 | Opal Jean M Norman | Speech-Language Pathologist | 4969 Old Adel Rd, Moultrie, GA 31788-1276 | 2008-06-16 |
1558440800 | Colquitt County Board of Education | Local Education Agency (LEA) | 348 Industrial Dr, Moultrie, GA 31788-1842 | 2006-11-06 |
1295378982 | Jamshaid Mukhtar Cheema | Physician Assistant | Turning Point Care Center, 3015 Veterans Pkway S, Moultrie, GA 31788-2397 | 2019-10-24 |
1508313164 | Publix Super Markets Inc | Durable Medical Equipment & Medical Supplies | 378 Veterans Pkwy N, Moultrie, GA 31788-4171 | 2016-09-01 |
1518347418 | Careconnect Health, Inc. | Clinic/Center | 358 Veterans Pkwy N, Moultrie, GA 31788-4171 | 2015-06-05 |
1528674439 | Lindsay Mobley | Pharmacist | 378 Veterans Pkwy N, Moultrie, GA 31788-4171 | 2020-09-17 |
1346727955 | Courtney Foy Edwards | Pharmacist | 378 Veterans Pkwy N, Moultrie, GA 31788-4171 | 2018-07-26 |
1538689757 | Lauren Milligan | Social Worker | 358 Veterans Pkwy N, Moultrie, GA 31788-4171 | 2017-06-20 |
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Taxonomy Code | 363LP0808X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Psych/Mental Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1538647581 | Kelly Suzanne Rychener | Nurse Practitioner | 3015 Veterans Pkwy S, Moultrie, GA 31788-6705 | 2018-08-01 |
1073946117 | Mary Ann Anderson-parris | Nurse Practitioner | 3015 Veterans Pkwy S, Moultrie, GA 31788-6705 | 2013-08-13 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1336740398 | Audline Maria Hodnett | Nurse Practitioner | 4805 W Village Way Se Apt 2208, Smyrna, GA 30080-9227 | 2020-11-05 |
1073111845 | George Mackel, Pmhnp-bc, LLC | Nurse Practitioner | 12034 Big Canoe, 400 Shetland Trace, Jasper, GA 30143 | 2020-10-14 |
1356958060 | Earl Delk | Nurse Practitioner | 3365 Ridgerock Way, Snellville, GA 30078-4176 | 2020-09-26 |
1609482991 | Tammy Haskins Bailey | Nurse Practitioner | 196 Laying Farm Rd Se, Milledgeville, GA 31061-9714 | 2020-09-22 |
1861007403 | Caring Clinic LLC | Nurse Practitioner | 114 Wrights Dr, Milledgeville, GA 31061 | 2020-09-10 |
1376156364 | Katrina Ransom Clark | Nurse Practitioner | 120 Walker Dr Nw, Milledgeville, GA 31061-9561 | 2020-08-28 |
1457963746 | Evelyn Ahiante Dennis | Nurse Practitioner | 3325 Emden Ct, Snellville, GA 30039-6047 | 2020-08-19 |
1194335620 | Jennifer Logan | Nurse Practitioner | 424 Scotts Way, Augusta, GA 30909-3135 | 2020-08-10 |
1750991592 | Jamie Rae Mccracken | Nurse Practitioner | 2538 Gordon Cir Se, Smyrna, GA 30080-8123 | 2020-08-06 |
1285244608 | Amcare Substance Abuse and Addiction Counseling | Nurse Practitioner | 3615 Hutchinson Rd Ste 203, Cumming, GA 30040-0501 | 2020-08-01 |
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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.