MR. GREGORY JOHN PECK (NPI# 1306814363) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306814363 |
| Entity Type | Individual |
| Full Name | MR. GREGORY JOHN PECK |
| Practice Address |
13511 S Springfield Rd Brandywine MD 20613-9232 |
| Practice Telephone | 3017824385 |
| Mailing Telephone | 3017824385 |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1710I1002X |
Military Health Care Provider Specialization: Independent Duty Corpsman |
Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | INDEPENDENT DUTY CORPSMAN | 1710I1002X | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396095642 | Gregory Leo Peck | Mechanotherapist | 9017 Buckeye Dr, Fontana, CA 92335-6007 | 2012-09-13 |
| 1194151506 | Gregory Allen Peck | Counselor | 1170 Pearl St, Eugene, OR 97401-3541 | 2013-09-17 |
| 1124298252 | Gregory Wayne Peck | Optometrist | 1765 Jonesboro Rd, Mcdonough, GA 30253-5969 | 2008-03-04 |
| 1316120827 | Gregory Lance Peck | Surgery | 125 Paterson St, New Brunswick, NJ 08901-1962 | 2007-12-07 |
| Street Address |
13511 S SPRINGFIELD RD |
| City | BRANDYWINE |
| State | MD |
| Zip Code | 20613-9232 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689176018 | Joseph Delonte Snider | Social Worker | 15912 Crain Hwy Ste B174, Brandywine, MD 20613 | 2018-03-01 |
| 1881104065 | Ally Infusion, LLC | Clinic/Center | 7651 Matapeake Bus Dr Ste 103, Brandywine, MD 20613 | 2017-10-02 |
| 1619418001 | Delante Mckinnon | Home Health Aide | 13306 Craine Hwy, Brandywine, MD 20613 | 2017-03-17 |
| 1346604295 | Physician Imaging of Washington Hospital Center, LLC | Radiology | 13950 Bradywine Road, Brandywine, MD 20613 | 2016-04-07 |
| 1053779116 | Medstar Surgery Center At Brandywine, LLC | Clinic/Center | 13950 Brandywine Road, Suite 100, Brandywine, MD 20613 | 2016-02-04 |
| 1649654948 | Innersense Behavioral Health, Inc. | Counselor | 13508 Stoney Creek Lane, Brandywine, MD 20613 | 2015-07-16 |
| 1043588817 | Neibauer Dental Care, PC | Dentist | 7651 Matapeake Business Drive Suite 106, Brandywine, MD 20613 | 2011-12-08 |
| 1376829804 | Danielle Lasure-bryant | Counselor | 11600 Cedarville Road, Brandywine, MD 20613 | 2011-10-28 |
| 1164664405 | Adenike Olayinka Gbenle | Dentist | 7450 Clymer Dr, Brandywine, MD 20613 | 2009-04-01 |
| 1841466919 | Communit Support System 'css LLC'. | Home Health | 6307 Brechib Dr, Brandywine, MD 20613 | 2008-05-07 |
| Find all providers in zip 20613 | ||||
| Taxonomy Code | 1710I1002X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Specialization | Independent Duty Corpsman |
| A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals. |
| Notes: Source: Bureau of Medicine and Surgery, Department of the Navy [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275143919 | Milton Mcintyre Brown Iv | Military Health Care Provider | 12610 Chanler Ln, Bowie, MD 20715-1302 | 2020-08-07 |
| 1548666415 | Janet Oliva | Military Health Care Provider | 6305 Riverdale Rd, Riverdale, MD 20737-2105 | 2014-11-05 |
| 1740693324 | Benjamin Graves | Military Health Care Provider | 3399 Strauss Ave Bldg 901, Indian Head, MD 20640-5164 | 2014-06-11 |
| 1497009187 | Devin P Sweet | Military Health Care Provider | 5813 Chinquapin Pkwy, 1st Floor, Baltimore, MD 21239-2555 | 2012-11-01 |
| 1083980932 | Ernest Theophilus Quimby Iv | Military Health Care Provider | Walter Reed Nmmc, Bldg 1 Suite 5103 8955 Wood Road, Bethesda, MD 20889-5628 | 2012-03-26 |
| 1447557202 | Louis Florentine Gonzales | Military Health Care Provider | 28k Queen Mary Ct, Chester, MD 21619-2528 | 2011-02-14 |
| 1497918635 | David Paul Horvath | Military Health Care Provider | 3399 Strauss Ave Ste 219, Indian Head, MD 20640-5164 | 2008-07-08 |
| 1932383593 | Michael A Walls | Military Health Care Provider | 3399 Strauss Ave, Suite 219, Indian Head, MD 20640-5164 | 2007-12-19 |
| 1316147457 | Michael Waters | Military Health Care Provider | 14900 Park Central Road, Naval Support Facility, Thurmont, MD 21788 | 2007-07-18 |
| 1538362041 | Elizabeth Ann Davenport | Military Health Care Provider | 734 Carpenter Park Apt A, Patuxent River, MD 20670-1308 | 2007-06-11 |
| Find all providers with the same taxonomy | ||||
| City | BRANDYWINE |
| Zip Code | 20613 |
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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.