CHARLES A PECK (NPI# 1912205840) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1912205840 |
Entity Type | Individual |
Full Name | CHARLES A PECK |
Credential | MD |
Practice Address |
10901 W 120th Ave Broomfield CO 80021-3418 |
Mailing Address |
2872 Gemini Loop Broomfield CO 80023-4678 |
Practice Telephone | 7203048941 |
Mailing Telephone | 6505156301 |
Enumeration Date | 2011-03-01 |
Last Update Date | 2011-03-01 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
MD432063 | PA | Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
OH | DEA | AP2835190 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1063446664 | Charles Curtis Peck | Pharmacist | Us Route 220, Tipton, PA 16684 | 2006-07-10 |
1942703608 | Charles A Peck | Social Worker | 180 Fairfield Ave, Bridgeport, CT 06604 | 2018-03-08 |
1922210426 | Charles Jeffery Peck | Psychiatry & Neurology | 2135 Southgate Road, Colorado Springs, CO 80906-2605 | 2007-05-04 |
Street Address |
10901 W 120TH AVE |
City | BROOMFIELD |
State | CO |
Zip Code | 80021-3418 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1790151793 | Martin Gaffey IIi | Physical Therapist | 10901 W 120th Ave, Suite 380, Broomfield, CO 80021-3418 | 2015-08-13 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1851941934 | Denver Restorative Dentistry Pllc | Dentist | 8181 Arista Place, Suite 140, Broomfield, CO 80021 | 2019-09-19 |
1205490398 | Amber Kay Kisser | Occupational Therapist | 7770 W 101st Ave, Westminster, CO 80021 | 2019-04-24 |
1871093138 | Samantha Ewing | Audiologist | 403 Summit Blvd., # 204, Broomfield, CO 80021 | 2018-02-13 |
1568978914 | Denver Recovery Center, LLC | Clinic/Center | 295 Interlocken Blvd Ste 400, Broomfield, CO 80021 | 2017-12-21 |
1730601477 | Elaine H Kim | Audiologist | 120 Edgeview Dr., Unit 6220, Broomfield, CO 80021 | 2017-07-14 |
1245605575 | Profound Fitness, LLC | Day Training, Developmentally Disabled Services | 7721 W 92nd Ave, Westminster, CO 80021 | 2015-12-11 |
1558785634 | Nichelle Francavilla Gurule | Chiropractor | 11336 W 104th Ave, Westminster, CO 80021 | 2014-02-10 |
1255770244 | Martha Ha | Dentist | 645 Flatiron Marketplace Dr Unit A, Broomfield, CO 80021 | 2013-06-23 |
1467737841 | Nathaniel Weidner | Pharmacist | 10350 Dover St. D28, Westminster, CO 80021 | 2011-10-17 |
1346475209 | Christine Marie Maren | Family Medicine | 8181 Arista Pl Unit 100, Broomfield, CO 80021 | 2009-05-21 |
Find all providers in zip 80021 |
Taxonomy Code | 261QA1903X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Ambulatory Surgical |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1588801377 | Children's North Surgery Center, LLC | Clinic/Center | 469 W. State Highway 7, Suite 2, Broomfield, CO 80023-8965 | 2009-01-15 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1043819873 | Lone Tree Surgery Center, LLC | Clinic/Center | 9218 Kimmer Dr Ste 101, Lone Tree, CO 80124-6733 | 2020-10-22 |
1770180986 | Audubon Ambulatory Surgery Center LLC | Clinic/Center | 6011 E Woodmen Rd Ste 200, Colorado Springs, CO 80923-2604 | 2020-10-01 |
1376155440 | Colorado Urologic Surgery Center, LLC | Clinic/Center | 3 Superior Dr Ste 301, Superior, CO 80027-8655 | 2020-08-20 |
1548870603 | Durango Surgery Center LLC | Clinic/Center | 1266 Escalante, Suite 101, Durango, CO 81303 | 2020-08-04 |
1366064032 | Care Dental Surgical Center of Denver LLC | Clinic/Center | 1111 S Abilene Ct, Aurora, CO 80012-4909 | 2020-05-15 |
1790320612 | Gs Campus Asc, LLC | Clinic/Center | Lafayette Surgery Center, 340 Exempla Circle, Suite #400, Lafayette, CO 80026 | 2019-11-14 |
1821642661 | Steamboat Surgery Center, LLC | Clinic/Center | 705 Marketplace Plz Ste 150, Steamboat Springs, CO 80487-1800 | 2019-07-30 |
1679134795 | Greeley Endoscopy Center, LLC | Clinic/Center | 8227 W 20th St, Greeley, CO 80634-3039 | 2019-06-28 |
1912460015 | Premier Eye Surgery Center of Colorado, LLC | Clinic/Center | 1050 W. South Boulder Road, Lafayette, CO 80026 | 2019-04-08 |
1659842128 | Milestone Surgical Center LLC | Clinic/Center | 9800 Pyramid Ct Ste 300, Englewood, CO 80112-2667 | 2018-12-10 |
Find all providers with the same taxonomy |
City | BROOMFIELD |
Zip Code | 80021 |
Please comment or provide details below to improve the information on CHARLES A PECK.
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.