MR. MICHAEL WAYNE PECK (NPI# 1881801017) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881801017 |
| Entity Type | Individual |
| Full Name | MR. MICHAEL WAYNE PECK |
| Credential | MS, ATC, LAT |
| Practice Address |
2240 Winrow Rd Fort Huachuca AZ 85613-5080 |
| Mailing Address |
4400 E Busby Dr Apt 1116j Sierra Vista AZ 85635-3935 |
| Practice Telephone | 5205339102 |
| Mailing Telephone | 5809194831 |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2014-01-18 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
ATH.J00300 | LA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477637130 | Michael Stephan Peck | Chiropractor | 660 W 7th St, San Pedro, CA 90731-3118 | 2006-10-25 |
| 1023026176 | Michael Lloyd Peck | Optometrist | 517 W Maine Ave, Enid, OK 73701-5542 | 2006-08-04 |
| 1881629806 | Michael J Peck | Chiropractor | 1530 Avenue O, Huntsville, TX 77340-4452 | 2006-07-11 |
| 1477193597 | Michael Andrew Peck | Case Manager/Care Coordinator | 1724 S Main St, Salt Lake City, UT 84115-1912 | 2020-01-07 |
| 1265825988 | Michael Lawrence Peck | Nurse Practitioner | 5301 E Grant Rd, Tucson, AZ 85712-2805 | 2015-03-05 |
| 1861823353 | Michael Peck | Counselor | 122 1st St, Chestertown, MD 21620-1983 | 2013-12-09 |
| 1770712424 | Michael Scott Peck | Podiatrist | 1155 Kelly Johnson Blvd, #310, Colorado Springs, CO 80920-3932 | 2009-07-02 |
| 1255543146 | Michael A. Peck | Dentist | 5038 Tennyson Pkwy, Suite A, Plano, TX 75024-2954 | 2007-05-04 |
| 1740328491 | Michael L Peck | Psychologist | 10642 Santa Monica Blvd, Los Angeles, CA 90025-4525 | 2007-02-02 |
| 1336210806 | Michael Peck | Specialist | 1130 Eagle Rock Rd, Colorado Springs, CO 80918-3906 | 2006-11-13 |
| Street Address |
2240 WINROW RD |
| City | FORT HUACHUCA |
| State | AZ |
| Zip Code | 85613-5080 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467053462 | Mary Eastep Gilstrap | Dental Hygienist | 2240 Winrow Rd, Fort Huachuca, AZ 85613-5080 | 2020-11-05 |
| 1154834844 | Paul G Foster | Dental Hygienist | 2240 Winrow Rd, Fort Huachuca, AZ 85613-5080 | 2017-11-16 |
| 1376087551 | Melissa Jones | Licensed Practical Nurse | 2240 Winrow Rd, Fort Huachuca, AZ 85613-5080 | 2016-12-07 |
| 1649726290 | Shandelon Garner | Registered Nurse | 2240 Winrow Rd, Fort Huachuca, AZ 85613-5080 | 2016-09-01 |
| 1841643558 | Kristine J Encinas | Licensed Vocational Nurse | 2240 Winrow Rd, Fort Huachuca, AZ 85613-5080 | 2016-07-18 |
| 1356791024 | Rashamel Smart | Dental Assistant | 2240 Winrow Rd, Fort Huachuca, AZ 85613-5080 | 2016-06-14 |
| 1285083170 | Annika Rose Dunmire | Dental Hygienist | 2240 Winrow Rd, Bldg 45505, Fort Huachuca, AZ 85613-5080 | 2016-06-10 |
| 1235588385 | Nicole Schiffer | Dental Hygienist | 2240 Winrow Rd, Fort Huachuca, AZ 85613-5080 | 2016-06-09 |
| 1881048619 | Kay Chaparro | Licensed Practical Nurse | 2240 Winrow Rd, Fort Huachuca, AZ 85613-5080 | 2016-04-18 |
| 1700230935 | Deborah De La Ossa | Clinic/Center | 2240 Winrow Rd, Fort Huachuca, AZ 85613-5080 | 2016-04-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457713794 | Robert Lee Kent Jr. | Registered Nurse | 2240 East Winrow Avenue, Fort Huachuca, AZ 85613 | 2016-03-25 |
| 1548628662 | George Fauber | Licensed Practical Nurse | 224 Winrow Ave, Usa Meddac, Rwbahc, Ft Huachuca, AZ 85613 | 2016-02-03 |
| 1013207810 | Gerald Michael Pastore | Counselor | 2240 Winrow Ave Fort Huachuca, Az, Usa Meddac, Rwbahc, Apo, AA 85613 | 2011-04-13 |
| 1306049895 | Raymond W. Bliss Army Health Center | Clinic/Center | 45005 Arizona Street, Fort Huachuca, AZ 85613 | 2007-06-11 |
| 1477617124 | Raymond W. Bliss Army Health Center | Military/U.S. Coast Guard Pharmacy | 2w Bliss Army Health Center 45001, Ft Huachuca, AZ 85613 | 2006-12-20 |
| 1114026150 | Raymond W Bliss Army Health Center | Military/U.S. Coast Guard Pharmacy | 2 W Bliss Army Health Ctr, Bldg 45001, Ft Huachuca, AZ 85613 | 2006-09-22 |
| 1013931484 | Mark Allen Hendrickson | Internal Medicine | Rwbahc, Bldg 45001, Sierra Vista Cboc, Ft Huachuca, AZ 85613 | 2006-07-27 |
| 1972538973 | Gail Pielack | Nurse Practitioner | Rwbahc, 2240 Winrow Rd, Fort Huachuca, AZ 85613 | 2006-07-11 |
| 1093755233 | National Vision, Inc. | Eyewear Supplier (Equipment, not the service) | Optical Center, Bldg 52030, Ft. Huachuca, AZ 85613 | 2006-06-07 |
| 1336119395 | Eric Nmi Danko | Dentist | 2240 E. Winrow Ave, Us Army Dental Activity, Fort Huachuca, AZ 85613 | 2006-01-24 |
| Find all providers in zip 85613 | ||||
| Taxonomy Code | 2255A2300X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Athletic Trainer |
| Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor’s degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration. |
| Notes: Source: National Athletic Trainers’ Association (www.NATA.org) [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316548746 | Cheyenne Varga | Specialist/Technologist | 918 W Nido Ave, Mesa, AZ 85210-7658 | 2020-11-03 |
| 1669073284 | Tiffany Fiesler | Specialist/Technologist | 6051 N Rockland Dr Apt B, Prescott Valley, AZ 86314-3187 | 2020-11-02 |
| 1104426063 | Desiree Pacheco | Specialist/Technologist | 2333 E Southern Ave Unit 2088, Tempe, AZ 85282-7647 | 2020-10-29 |
| 1427658756 | Marlenne Adair Escobar-mendoza | Specialist/Technologist | 1705 South San Francisco Street, Flagstaff, AZ 86001 | 2020-10-27 |
| 1740889815 | Jory Walthour | Specialist/Technologist | 4545 E Downing St, Mesa, AZ 85205-6319 | 2020-10-20 |
| 1225637317 | Alexsys Cameran Stroh | Specialist/Technologist | 1349 S Burlington St, Flagstaff, AZ 86001-2446 | 2020-10-20 |
| 1952900151 | Joseph Espinoza | Specialist/Technologist | 505 S Roosevelt Rd Apt I6, Mesa, AZ 85202-1702 | 2020-10-20 |
| 1093314445 | Christopher Murphy | Specialist/Technologist | 301 E Bromley St, Tucson, AZ 85704-5704 | 2020-10-17 |
| 1942807052 | Thomas Langer | Specialist/Technologist | 1317 S Terrace Rd, Box #156, Tempe, AZ 85281 | 2020-10-02 |
| 1689280034 | Jordan Nash-boulden | Specialist/Technologist | 6000 S Lakeshore Dr, Tempe, AZ 85283-3049 | 2020-09-21 |
| Find all providers with the same taxonomy | ||||
| City | FORT HUACHUCA |
| Zip Code | 85613 |
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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.