KASSIE PECK, PLLC (NPI# 1316350036) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316350036 |
| Entity Type | Organization |
| Organization Name | KASSIE PECK, PLLC |
| Practice Address |
2257 W Washington St Broken Arrow OK 74012-6703 |
| Practice Telephone | 4055379101 |
| Practice Fax Number | 9185124823 |
| Mailing Telephone | 4055379101 |
| Mailing Fax Number | 9185124823 |
| Enumeration Date | 2014-06-10 |
| Last Update Date | 2014-06-10 |
| Authorized Official Name | MRS. KASSIE ANN PECK (OCCUPATIONAL THERAPIST) |
| Authorized Official Telephone | 4055379101 |
| Authorized Official Credential | MOT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oklahoma Business Registrations | KASSIE PECK, PLLC | 25307 E 67th St South, Broken Arrow, OK 74014 |
| Street Address |
2257 W WASHINGTON ST |
| City | BROKEN ARROW |
| State | OK |
| Zip Code | 74012-6703 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134349921 | Rachel Nicole Ottley | Occupational Therapist | 2257 W Washington St, Broken Arrow, OK 74012-6703 | 2007-04-26 |
| 1174139323 | Taylor Nicole Collier | Occupational Therapist | 2257 W Washington St, Broken Arrow, OK 74012-6703 | 2020-09-22 |
| 1407328628 | Makina Jane Kelley | Occupational Therapist | 2257 W Washington St, Broken Arrow, OK 74012-6703 | 2018-12-28 |
| 1053883967 | Ashlee Potter | Occupational Therapist | 2257 W Washington St, Broken Arrow, OK 74012-6703 | 2018-12-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154949139 | Bonnie Jordan James | Pharmacist | 915 E Kenosha St, Broken Arrow, OK 74012 | 2020-07-07 |
| 1548814874 | Flawless Smile Dentistry of Ba Pllc | Dentist | 2319 N. 9th Street, Broken Arrow, OK 74012 | 2019-07-25 |
| 1780236653 | Carefirst Pharmacy Inc. | Pharmacy | 2530 N. Elm Pl., Broken Arrow, OK 74012 | 2019-07-11 |
| 1043871213 | Stacy Lynn Mitchell | Counselor | 2035 W. Houson St., Suite A, Broken Arrow, OK 74012 | 2019-06-27 |
| 1497319297 | Sara Hart | Internal Medicine | 420 W. Stone Wood Drive, Broken Arrow, OK 74012 | 2019-04-26 |
| 1699262386 | Fulps Family Eye Care, LLC | Optometrist | 3300 S Aspen Ave Ste D, Broken Arrow, OK 74012 | 2018-04-18 |
| 1598284358 | Stephanie Sue Mcquarters | Clinical Medical Laboratory | 1840 South Lion Avenue, Broken Arrow, OK 74012 | 2017-09-13 |
| 1477072460 | Kama Rae Gettings | Nurse Practitioner | 4623 W. Kenosha St, Broken Arrow, OK 74012 | 2017-09-12 |
| 1689196727 | Kristen Sherie' Snyder | Case Manager/Care Coordinator | 1324 North Umbrella Avenue, Broken Arrow, OK 74012 | 2017-07-11 |
| 1699216754 | Hillside Wellness Plllp | Chiropractor | 2311 N 9th St, Suite 101, Broken Arrow, OK 74012 | 2017-03-09 |
| Find all providers in zip 74012 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619371473 | Dermatology & Allergy Solutions LLC | Clinic/Center | 4716 South Urbana Street, Broken Arrow, OK 74012 | 2014-10-22 |
| 1932344835 | Collaborative Therapy Services Inc | Clinic/Center | 2221 W Detroit St, Broken Arrow, OK 74012-3628 | 2008-12-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497361273 | Allied Wound Care Specialist Pllc | Clinic/Center | 1145 W I 240 Service Rd Ste F100, Oklahoma City, OK 73139-2134 | 2020-09-17 |
| 1588213441 | Drayer Physical Therapy Oklahoma LLC | Clinic/Center | 11319 S State Highway 51 Ste 900, Coweta, OK 74429-7163 | 2019-09-04 |
| 1568021459 | Healthworks Medical Group of Oklahoma P C | Clinic/Center | 915 E Owen K Garriott Rd Ste 202, Enid, OK 73701-6156 | 2019-06-13 |
| 1356803308 | Saint Medical Group, LLC | Clinic/Center | 2315 Parkview Dr Ste 2a, El Reno, OK 73036-2149 | 2019-04-01 |
| 1992267959 | Saint Medical Group, LLC | Clinic/Center | 2315 Parkview Dr Ste 2b, El Reno, OK 73036-2149 | 2019-04-01 |
| 1831698752 | Healthworks Medical Group of Oklahoma P C | Clinic/Center | 109 Ne 40th St, Oklahoma City, OK 73105-2415 | 2018-02-06 |
| 1386185353 | Neuropathy Treatment Clinic of Oklahoma LLC | Clinic/Center | 1810 E 15th St Ste D, Tulsa, OK 74104-4611 | 2017-03-10 |
| 1942757554 | Seiling Municipal Hospital Authority | Clinic/Center | 809 Ne Hwy 60, Seiling, OK 73663 | 2016-09-01 |
| 1255784393 | Kmz Medical Solutions, Pllc | Clinic/Center | 800 W. St., Ste 102-c, Edmond, OK 73013-7920 | 2016-07-13 |
| 1417303801 | Paradigm Hormones Tulsa, Pllc | Clinic/Center | 6316 E 102nd St, Tulsa, OK 74137-7061 | 2016-05-04 |
| Find all providers with the same taxonomy | ||||
| City | BROKEN ARROW |
| Zip Code | 74012 |
Please comment or provide details below to improve the information on KASSIE PECK, PLLC.
| 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.