MARC ROGER PECK (NPI# 1619979424) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619979424 |
| Entity Type | Individual |
| Full Name | MARC ROGER PECK |
| Credential | MD |
| Practice Address |
377 Sylvan Lake Road Suite 210 Eagle CO 81631 |
| Mailing Address |
Po Box 1749 Edwards CO 81632-1749 |
| Practice Telephone | 9709266340 |
| Practice Fax Number | 9709266348 |
| Mailing Telephone | 9709266340 |
| Mailing Fax Number | 9709266348 |
| Enumeration Date | 2005-08-11 |
| Last Update Date | 2015-11-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 31510 | CO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 01315100 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255344297 | Marc Robert Peck | Radiology | 1810 Shore Rd, Northfield, NJ 08225-2220 | 2006-08-14 |
| 1235552365 | Marc Peck | Counselor | 1706 Wayne Memorial Dr, Goldsboro, NC 27534-2240 | 2014-01-24 |
| Street Address |
377 SYLVAN LAKE ROAD SUITE 210 |
| City | EAGLE |
| State | CO |
| Zip Code | 81631 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215534938 | Allergy, Asthma & Immunology of The Rockies, PC | Allergy & Immunology | 377 Sylvan Lake Road, Suite #140, Eagle, CO 81631 | 2020-10-06 |
| 1518564368 | Allergy, Asthma & Immunology of The Rockies, PC | Allergy & Immunology | 377 Sylvan Lake Road, Suite #140, Eagle, CO 81631 | 2020-10-05 |
| 1215553409 | Colorado Mountain Medical, LLC | Dermatology | 377 Sylvan Lake Road, Suite 210, Eagle, CO 81631 | 2020-06-23 |
| 1417573619 | Colorado Mountain Medical, LLC | Clinic/Center | 377 Sylvan Lake Road, Suite 210, Eagle, CO 81631 | 2020-06-23 |
| 1578110748 | Elie Hsu | Physical Therapist | 377 Sylvan Lake Road, Eagle, CO 81631 | 2019-08-22 |
| 1174170427 | Vail Clinic, Inc. | Clinic/Center | 377 Sylvan Lake Road, Eagle, CO 81631 | 2019-08-21 |
| 1265099451 | Krystal Schlegel | Physical Therapist | 377 Sylvan Lake Road, Eagle, CO 81631 | 2019-05-22 |
| 1700148525 | Tessa M. Beal | Family Medicine | 377 Sylvan Lake Road, Suite 210, Eagle, CO 81631 | 2012-06-08 |
| 1962779538 | Carly Jill Baker | Occupational Therapist | 377 Sylvan Lake Road, Eagle, CO 81657 | 2011-11-25 |
| 1780978122 | Valley View Hospital Association | Family Medicine | 377 Sylvan Lake Road, Suite 140, Eagle, CO 81631-4291 | 2011-06-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215549662 | Andrea Browning | Social Worker | 2549 Salt Creek Road, Eagle, CO 81631 | 2020-08-18 |
| 1689213829 | Erin E Johnson | Pharmacist | 0103 Market Street, Eagle, CO 81631 | 2020-01-06 |
| 1821653825 | Lauren Lyn Ruhl | Counselor | 360 Eby Creek Road, Eagle, CO 81631 | 2019-05-06 |
| 1134626401 | Dawn Allison Nichols | Counselor | 137 Howard, Eagle, CO 81631 | 2018-04-12 |
| 1750886776 | Daniel Israel | Counselor | 137 Howard St., Eagle, CO 81631 | 2018-03-30 |
| 1962903005 | Lisa K Johnson | Massage Therapist | 717a Sylvan Lake Road, Eagle, CO 81631 | 2018-02-23 |
| 1922525815 | Susan Robinson | Physical Therapist | 1143 Capitol St, Unit 102b, Eagle, CO 81631 | 2017-08-23 |
| 1184148157 | Hallie Mclaughlin | Dental Hygienist | 530 Founders Ave, Eagle, CO 81631 | 2017-08-01 |
| 1780125252 | Brendan Quinn | Pharmacist | 264 Fulford Drive, Eagle, CO 81631 | 2017-03-16 |
| 1710428883 | Eagle Orthodontics, PC | Dentist | 011 Eagle Park Dr., Eagle, CO 81631 | 2017-03-09 |
| Find all providers in zip 81631 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801156351 | Martin J Gabica | Family Medicine | 2323 E Buckskin Ct, Eagle, ID 83616-2931 | 2012-05-17 |
| 1124390687 | Jamesd Elwood Eshenaur | Family Medicine | 981 N Elkriver Way, Eagle, ID 83616-5448 | 2012-01-31 |
| 1871823203 | Integrative Medicine Clinic | Family Medicine | 960 Chambers Ave, A-203, Eagle, CO 81631 | 2010-01-07 |
| 1538214184 | Daniel Stewart Knorpp | Family Medicine | 3217 Bavaria Street, Eagle, ID 83616-5171 | 2007-01-24 |
| 1043389356 | Angela Ammon | Family Medicine | 377 Sylvan Lake Rd Ste 220, Eagle, CO 81631-0129 | 2006-11-08 |
| 1053494146 | Brook Medical Pllc | Family Medicine | 1281 E. Iron Eagle Dr, Eagle, ID 83616-9117 | 2006-10-23 |
| 1043322217 | Heidi A Herold | Family Medicine | 435 S Eagle Rd Ste 100, Eagle, ID 83616-6018 | 2006-08-31 |
| 1194835546 | River Medical Family Medicine, Pllc | Family Medicine | 100 Cottonwood Ct Bldg D, Suite 150, Eagle, ID 83616-6576 | 2006-08-30 |
| 1124030093 | Linda D Burke Md Pa | Family Medicine | 445 S. Fitness Place, Eagle, ID 83616 | 2006-08-12 |
| 1376581124 | Linda D Burke | Family Medicine | 445 S Fitness Pl, Ste130, Eagle, ID 83616-6552 | 2006-06-03 |
| Find all providers in EAGLE | ||||
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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.