DR. LARRY BRAD PECK (NPI# 1366491334) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366491334 |
| Entity Type | Individual |
| Full Name | DR. LARRY BRAD PECK |
| Credential | PSYD |
| Practice Address |
44 N Medical Dr Slc UT 84113-1105 |
| Mailing Address |
3908 S 2175 E Slc UT 84124-1718 |
| Practice Telephone | 8015848533 |
| Mailing Telephone | 8016478010 |
| Enumeration Date | 2006-05-08 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
98-351353-2501 | UT | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730174129 | Larry Don Peck | Optometrist | 716 Avenue G, Fort Madison, IA 52627-2927 | 2005-09-13 |
| Street Address |
44 N MEDICAL DR |
| City | SLC |
| State | UT |
| Zip Code | 84113-1105 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811945637 | Michelle Coles Webster | Speech-Language Pathologist | 44 N Medical Dr, Slc, UT 84113-1105 | 2006-05-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386111060 | Melissa Marie Dixon | Psychologist | Primary Children's Hospital Outpatient Services, 81 South Mario Capecchi Drive, Salt Lake City, UT 84113 | 2018-10-31 |
| 1366965618 | Ashley Stuart | Psychologist | 44 North Mario Capecchi Drive, Salt Lake City, UT 84113 | 2017-07-19 |
| 1487945135 | Justin C Wheeler | Pediatrics | 81 N Mario Capecchi Dr Fl 4, Salt Lake City, UT 84113 | 2011-04-29 |
| 1154612117 | Dana Boucek | Pediatrics | 100 North Mario Capecchi Dr., Primary Children's, Salt Lake City, UT 84113 | 2011-04-26 |
| 1285959502 | Anna Katherine Eyre Ermarth | Pediatrics | 81 Mario Capecchi, Salt Lake City, UT 84113 | 2010-03-30 |
| 1457682072 | Elizabeth K Cho | Nurse Practitioner | 100 North Mario Cappechi Dr., Salt Lake City, UT 84113 | 2010-01-21 |
| 1528290848 | Nancy Crandell Brown | Nurse Practitioner | 100 North Mario Cappechi Drive, Salt Lake City, UT 84113 | 2009-08-20 |
| 1679708481 | Primary Children's Medical Center | General Acute Care Hospital | 100 No. Mario Capecchi Drive, Salt Lake, UT 84113 | 2009-05-22 |
| 1467697235 | Tara Hook | Physical Therapist | 100 North Mario Capecchi Dr, Salt Lake City, UT 84113 | 2008-12-09 |
| 1144474768 | Jennifer K Workman | Pediatrics | 100 N Mario Capecchi Drive, Pediatric Crtical Care, Primary Children's Hospital, Salt Lake City, UT 84113 | 2008-11-10 |
| Find all providers in zip 84113 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265467831 | Melvin F. Nosanchuk | Psychologist | 1646 Kensington Ave, Slc, UT 84105-2806 | 2006-07-12 |
| 1740894336 | Nicole Demke | Psychologist | 515 S 700 E Ste 2a, Slc, UT 84102-2855 | 2020-09-02 |
| 1275985624 | Lindsay D Wilson-barlow | Psychologist | 1208 E 3300 S, Slc, UT 84106-2522 | 2016-07-11 |
| 1306099007 | Tanya Michelle Miller | Psychologist | 500 Foothill Dr, Slc, UT 84148-0001 | 2008-10-28 |
| 1568515013 | George F Mooney | Psychologist | 50 N Medical Dr, Slc, UT 84132-0001 | 2007-01-19 |
| 1912055229 | Paul David Colte | Psychologist | 100 N Medical Dr, Slc, UT 84113-1103 | 2007-01-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205433059 | Steven Lucero | Psychologist | 93 S 1250 E, Logan, UT 84321-6770 | 2020-10-05 |
| 1023627759 | Wasatch Front Wellness, Pllc | Psychologist | 940 N 400 E Ste 3, North Salt Lake, UT 84054-1945 | 2020-07-29 |
| 1376165530 | Kirsten Leigh Graham | Psychologist | 351 W University Blvdgeneral Classrooms 308-o, General Classrooms 308-o, Cedar City, UT 84720 | 2020-05-11 |
| 1467073833 | Realign Psychology LLC | Psychologist | 1042 E Fort Union Blvd, #1085, Midvale, UT 84047-1800 | 2020-04-27 |
| 1508404344 | Rith Counseling and Assessment Pllc | Psychologist | 10432 S 4000 W, South Jordan, UT 84009-5729 | 2019-12-11 |
| 1780230433 | Carolynne Elizabeth Baron | Psychologist | Va Salt Lake City Healthcare System 500 Foothill Drive, Salt Lake City, UT 84148-0001 | 2019-08-16 |
| 1255999637 | Thomas Golightly | Psychologist | 1500 Wsc Byu, Provo, UT 84602 | 2019-05-31 |
| 1639732571 | Scott A Baldwin | Psychologist | 1190 N 900 E Ofc 285, Provo, UT 84604-3536 | 2019-04-16 |
| 1407311087 | Hiu Wai Caldwell | Psychologist | 796 E. Pacific Drive Suite B, American Fork, UT 84003-8400 | 2019-02-07 |
| 1992273734 | Tracy Ellis | Psychologist | 70 N Main St Ste 104, Bountiful, UT 84010-6115 | 2018-11-09 |
| Find all providers with the same taxonomy | ||||
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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.