JASON RUSSELL PECK MD
NPI 1235290693
Pediatrics - Pediatric Critical Care Medicine in Columbia, SC

Q: What is Jason Peck's NPI number?

The NPI number for Jason Peck is 1235290693. It was assigned to this individual provider in the NPPES registry on December 12, 2006.

Q: What is Jason Peck's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Critical Care Medicine, with taxonomy code 2080P0203X.

Q: When was this NPI record last updated?

The NPPES record for Jason Peck was last updated on March 23, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since December 12, 2006PECOS Enrolled

9 RICHLAND MEDICAL PARK DR STE 530, COLUMBIA, SC 29203(803) 434-4603(803) 434-3866 Get Directions Write a Review

NPPES record last updated: March 23, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 23, 2018, Mar 16, 2018 (2 updates tracked since 2018).

On this page

About Jason Russell Peck Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JASON RUSSELL PECK MD (NPI 1235290693) is an individual pediatric critical care medicine provider in Columbia, South Carolina, licensed in South Carolina (33116) and active in the NPI registry since December 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1235290693

Entity TypeIndividualMale

Primary Taxonomy2080P0203X

Provider Legal NameJASON RUSSELL PECKCredential: MD

Location Address9 RICHLAND MEDICAL PARK DR STE 530Columbia, SC 29203-6870

Mailing AddressPo Box 743904Atlanta, GA 30374-3904 · (803) 269-7320 · Fax (803) 296-7330

Phone(803) 434-4603

Fax(803) 434-3866

Sole ProprietorNo

Enumeration DateDecember 12, 2006

Last NPPES UpdateMarch 23, 20182 updates tracked since enumeration

✔ NPI 1235290693 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatrics · Pediatric Critical Care MedicineAllopathic & Osteopathic Physicians

Taxonomy Code2080P0203X

Licenses✔ Licensed in SC · 33116✔ Licensed in CO · 45451

Definition

A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists.

Also ListedPediatricsTaxonomy 208000000X · License 33116 (SC), L8471 (TX)

9 RICHLAND MEDICAL PARK DR STE 530, Columbia, SC 29203

Open in Google Maps ↗

Other Identifiers 1

Medicaid31162SC

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jason Russell Peck Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EMILY FOREMAN INGRAM

Pediatrics (Pediatric Critical Care Medicine)