CARRIE PEACOCK (NPI# 1770776858) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770776858 |
| Entity Type | Individual |
| Full Name | CARRIE PEACOCK |
| Credential | M.S., BCBA |
| Practice Address |
1155 Cully Rd Cordova TN 38018-8502 |
| Practice Telephone | 9016242454 |
| Mailing Telephone | 9016242454 |
| Enumeration Date | 2007-08-22 |
| Last Update Date | 2007-08-28 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TM1800X |
Psychologist Specialization: Mental Retardation & Developmental Disabilities |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912309295 | Carrie Peacock | Physician Assistant | 820 S Mcclellan St Ste 300, Spokane, WA 99204-2450 | 2014-09-18 |
| Street Address |
1155 CULLY RD |
| City | CORDOVA |
| State | TN |
| Zip Code | 38018-8502 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790255602 | Laura Ballard-scott | Behavioral Analyst | 1155 Cully Rd, Cordova, TN 38018-8502 | 2018-12-04 |
| 1164940474 | Lisa Wallace | Behavioral Analyst | 1155 Cully Rd, Cordova, TN 38018-8502 | 2017-09-07 |
| 1700329323 | Allison Ribley | Behavioral Analyst | 1155 Cully Rd, Cordova, TN 38018-8502 | 2016-11-30 |
| 1992189385 | William Talbert | Behavioral Analyst | 1155 Cully Rd, Cordova, TN 38018-8502 | 2015-07-15 |
| 1386041366 | William Van Justice IIi | Behavioral Analyst | 1155 Cully Rd, Cordova, TN 38018-8502 | 2014-11-19 |
| 1831535145 | Sarah Elisabeth Vasquez | Behavioral Analyst | 1155 Cully Rd, Cordova, TN 38018-8502 | 2013-05-14 |
| 1730525049 | Shakeesha K Washington | Behavioral Analyst | 1155 Cully Rd, Cordova, TN 38018-8502 | 2013-05-14 |
| 1144666553 | Levon Johnson Jr. | Behavioral Analyst | 1155 Cully Rd, Cordova, TN 38018-8502 | 2013-05-13 |
| 1619275310 | James Joshua Short | Counselor | 1155 Cully Rd, Cordova, TN 38018-8502 | 2011-03-03 |
| 1740580182 | Shallis Michelle Gonda | Community/Behavioral Health | 1155 Cully Rd, Cordova, TN 38018-8502 | 2010-11-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588264428 | Shaquia Janai Harris | Behavior Technician | 1079 N Houston Levee Road, Cordova, TN 38018 | 2020-10-29 |
| 1366041493 | Cynthia Brantley | Behavior Technician | 1079 N Houston Levee Rd, Cordova, TN 38018 | 2020-10-20 |
| 1558901736 | At Home Physical Rehabilitation Group, LLC | Physical Therapy Assistant | 856 Willow Tree Circle, Cordova, TN 38018 | 2020-01-15 |
| 1538703038 | Scott Eric Balogh | Psychiatry & Neurology | 65 Germantown Court, Suite 203, Cordova, TN 38018 | 2019-10-29 |
| 1851871305 | Joanna H Fussell | Behavioral Analyst | 8066 Walnut Run Suite 102, Cordova, TN 38018 | 2018-08-15 |
| 1841736097 | A Guardian Care Group | Home Health | 10164 Green Moss, Cordova, TN 38018 | 2017-01-12 |
| 1497127146 | Functional Independence, Inc. | Home Health | 270 German Oak Dr., Memphis, TN 38018 | 2015-10-21 |
| 1679984363 | Tiffany Masters Redfern | Obstetrics & Gynecology | 521 Riveredge Dr W, Cordova, TN 38018 | 2014-05-15 |
| 1295073427 | Mitchell Wyman Alvarez | Optometrist | 2075 N. Germantown Pkwy, Memphis, TN 38018 | 2013-01-23 |
| 1578827531 | Chiung Feng Hsu | Dentist | 831 Timber Creek Dr #1, Cordova, TN 38018 | 2012-06-25 |
| Find all providers in zip 38018 | ||||
| Taxonomy Code | 103TM1800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Mental Retardation & Developmental Disabilities |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265681936 | Paul R. Malanga | Psychologist | 9395 Garden Woods Dr, Cordova, TN 38016-4729 | 2008-09-17 |
| 1194999615 | Nicole Marie Bichelman | Psychologist | 862 Winterfields Dr., Cordova, TN 38018-7965 | 2008-04-15 |
| 1992981724 | Sandra Cea | Psychologist | 1155 Cully Rd, Cordova, TN 38018-8502 | 2008-01-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609351766 | Superior Residential Solutions, LLC | Psychologist | 5225 Rocky Ford Ln, Arlington, TN 38002-4833 | 2018-09-25 |
| 1700071651 | Timothy Cripps | Psychologist | 1778 Penshurst Dr, Collierville, TN 38017-9104 | 2007-09-12 |
| 1801007984 | David H. Craig | Psychologist | 202 Sunnymeade Dr, Columbia, TN 38401-5225 | 2007-05-24 |
| 1689796500 | Liming Zhou | Psychologist | 6117 Lamb Woods Dr, Bartlett, TN 38135-9256 | 2007-04-03 |
| 1629108642 | George Elliott Zukotynski | Psychologist | 3229 Nolen Ln, Franklin, TN 37064-6222 | 2007-03-07 |
| 1053446757 | Kenneth Michael Macurik | Psychologist | 3543 Philwood Ave, Memphis, TN 38122-4557 | 2007-02-22 |
| 1841346095 | Maurice Butler Jr. | Psychologist | 4942 Noel Mission Dr, Memphis, TN 38125-4783 | 2007-01-27 |
| 1316988579 | Michael E Rohr | Psychologist | 550 Lazenby Dr, Somerville, TN 38068-5030 | 2006-06-09 |
| 1396200424 | Gary Brown | Psychologist | 302 Broadway St, Martin, TN 38237-2455 | 2019-02-02 |
| 1447563044 | Melissa Luke Gonzalez | Psychologist | 1101 Carter St, Chattanooga, TN 37402-5017 | 2010-07-23 |
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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.