REGINALD DEMETRIUS PEEK (NPI# 1306076021) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306076021 |
| Entity Type | Individual |
| Full Name | REGINALD DEMETRIUS PEEK |
| Credential | MD |
| Practice Address |
950 Indian Trl Rd Nw Suite 5d Lilburn GA 30047-1721 |
| Mailing Address |
2419 Laurel Cir Nw Atlanta GA 30311-1237 |
| Practice Telephone | 4046005563 |
| Mailing Telephone | 4042779264 |
| Enumeration Date | 2009-07-15 |
| Last Update Date | 2016-06-13 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 063002 | GA | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 003152731A | 05 |
| Street Address |
950 INDIAN TRL RD NW SUITE 5D |
| City | LILBURN |
| State | GA |
| Zip Code | 30047-1721 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508038076 | Fabulous Dentistry and Orthodontics PC | Dentist | 950 Indian Trl Rd Nw, Suite 3-g, Lilburn, GA 30047-1721 | 2008-03-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750861217 | Latrina S Walden | Nurse Practitioner | 887 Ryan Lane, Lilburn, GA 30047 | 2018-08-15 |
| 1811483928 | Olivia Oyegunle | Optometrist | 4153 Lawrenceville Hwy Nw Ste 5, Lilburn, GA 30047 | 2018-07-02 |
| 1932619285 | Mpm Creative, LLC | Speech-Language Pathologist | 1560 Hewatt Rd, Lilburn, GA 30047 | 2017-10-01 |
| 1528515186 | Smith Dental Care of Lilburn, Inc. | Dentist | 3100 Five Forks Trickham Rd Suite 201, Lilburn, GA 30047 | 2016-09-01 |
| 1891143244 | Choices Behavioral Alternatives | Counselor | 4037 Darling Court, Suite B, Lilburn, GA 30047 | 2016-05-26 |
| 1235595687 | Georgia Dental Associates | Clinic/Center | 3100 Five Forks Trickum Road Suite 201, Lilburn, GA 30047 | 2016-01-14 |
| 1912382144 | Sangeetha Asokan | Dentist | 609, Beaver Ruin Road, Tebo Dental for Kids, Lilburn, GA 30047 | 2015-07-29 |
| 1467836403 | Pamela Neal | Registered Nurse | 3315 Landingview Ct, Lilburn, GA 30047 | 2015-07-18 |
| 1699172452 | Josie Kou, Kulah Curran | Registered Nurse | 3708 Tamer Ln, Lilburn, GA 30047 | 2014-11-21 |
| 1184039380 | Cheryl Lee | Chiropractor | 5014 Stone Mountain Hwy, Suite C, Lilburn, GA 30047 | 2014-06-25 |
| Find all providers in zip 30047 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649885179 | Rakiya Parker | Specialist | 4814 Stone Mountain Hwy Ste 9, Lilburn, GA 30047-4649 | 2020-09-11 |
| 1962736520 | Donna Rogers | Specialist | 5335 Five Forks Trickum Rd Sw, Lilburn, GA 30047-6753 | 2009-09-29 |
| 1609025980 | Alternative and Comprehensive Medicine | Specialist | 4250 Stone Mountain Hwy # 78, Suite 102, Lilburn, GA 30047-3340 | 2008-09-11 |
| 1154511426 | Yolanda P Bowdre | Specialist | 3752 Preservation Cir, Lilburn, GA 30047-7063 | 2007-08-01 |
| 1538228465 | Laura Dennison | Specialist | 4145 Lawrenceville Hwy., Ste. 10a, Lilburn, GA 30044 | 2006-12-06 |
| 1124103270 | Afroz Rahman | Specialist | 449 Pleasant Hill Rd Nw, Lilburn, GA 30047-2770 | 2006-10-26 |
| 1932216785 | Theodore Miko | Specialist | 4391 Fallowfield Ln Sw, Lilburn, GA 30047-7405 | 2006-08-25 |
| 1154364883 | Dunwoody Seniors Inc | Specialist | 375 Rockbridge Road, Suite 172 Box 242, Lilburn, GA 30047 | 2006-06-13 |
| 1295727527 | Felicity M. Warren | Specialist | 3993 Lawrenceville Hwy Nw Ste 110, Lilburn, GA 30047-2831 | 2005-08-23 |
| 1427322528 | Premier Pain Management Inc | Specialist | 3993 Lawrenceville Hwy Nw, Suite 110, Lilburn, GA 30047-2897 | 2012-03-07 |
| Find all providers in LILBURN | ||||
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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.