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AMANDA B PEACOCK ACNP
NPI 1669721155
Nurse Practitioner - Acute Care in Jacksonville, FL

Active since August 30, 2012PECOS Enrolled
3 SHIRCLIFF WAY, SUITE 714, JACKSONVILLE, FL 32204(904) 308-2006(904) 308-7111 Get Directions Write a Review

NPPES record last updated: February 11, 2021. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Amanda B Peacock Acnp NPPES

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

AMANDA B PEACOCK ACNP (NPI 1669721155) is an individual acute care provider in Jacksonville, Florida, licensed in Florida (9349014) and active in the NPI registry since August 2012. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1669721155
Entity TypeIndividualFemale
Primary Taxonomy363LA2100X
Provider Legal NameAMANDA B PEACOCKCredential: ACNP
Location Address3 SHIRCLIFF WAY, SUITE 714Jacksonville, FL 32204-4757
Mailing Address3599 University Blvd SJacksonville, FL 32216-4252 · (904) 345-7776 · Fax (904) 345-7772
Phone(904) 308-2006
Fax(904) 308-7111
Sole ProprietorNo
Enumeration DateAugust 30, 2012
Last NPPES UpdateFebruary 11, 2021
NPPES CertifiedFebruary 11, 2021
✔ NPI 1669721155 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Acute CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2100X
License✔ Licensed in FL · 9349014
3 SHIRCLIFF WAY, Jacksonville, FL 32204
Open in Google Maps ↗

Other Identifiers 2

OtherP01118046FL · Railroad Medicare
OtherY0E3SFL · Bcbs-fl

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Amanda B Peacock Acnp 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.

Medicare Billing Reassignments

2

Medicare enrollment records show Amanda Peacock reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

St Vincents Ambulatory Care Inc
Same address
Neurological Surgery
2 SHIRCLIFF WAY, SUITE 600
Jacksonville, FL 32204
  • Reassigned Medicare billing, Florida enrollment
  • Medicare enrollment name: St Vincent's Ambulatory Care Inc
  • 544 clinicians in this Medicare group
NPI 1417987124 (904) 308-6769
Physical Medicine Specialists, Inc.
5.4 mi
Physical Medicine & Rehabilitation
3901 UNIVERSITY BLVD S, SUITE 103
Jacksonville, FL 32216
  • Reassigned Medicare billing, Florida enrollment
  • 92 clinicians in this Medicare group
NPI 1952343261 (904) 345-7373

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32204 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$87.62 typical visit price
range $56.00 – $171.84
Typical copayment $21.90 (range $14.00 – $42.96)
Most-billed visit code 99203
Established Patient
$99.16 typical visit price
range $17.57 – $139.16
Typical copayment $24.79 (range $4.39 – $34.79)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

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

MIELKE GROUP, INC.
Clinical Neuropsychologist
3 SHIRCLIFF WAY, SUITE #333
JACKSONVILLE, FL 32204
Duval County (904) 607-2079
STEVEN H SCHWARTZ O.D.
Optometrist
3 SHIRCLIFF WAY, STE 122
JACKSONVILLE, FL 32204
Duval County (904) 388-3109
BRUCE A HARTWIG MD PA
Specialist
3 SHIRCLIFF WAY, SUITE 752
JACKSONVILLE, FL 32204
Duval County (904) 389-6226
DR. STEPHEN KUEHN MD
Internal Medicine (Gastroenterology)
3 SHIRCLIFF WAY, SUITE 400
JACKSONVILLE, FL 32204
Duval County (904) 398-7205
PAULA KIM SMITH CWHNP
Nurse Practitioner (Obstetrics & Gynecology)
3 SHIRCLIFF WAY, STE 200 DILLON BLDG
JACKSONVILLE, FL 32204
Duval County (904) 384-3699
SUNSHINE SPINE AND PAIN, PA
Physical Medicine & Rehabilitation (Pain Medicine)
3 SHIRCLIFF WAY, SUITE 610
JACKSONVILLE, FL 32204
Duval County (904) 292-2700
MR. SEABURY DENNISON STONEBURNER JR. MD
Internal Medicine (Nephrology)
3 SHIRCLIFF WAY, SUITE 658
JACKSONVILLE, FL 32204
Duval County (904) 389-9681
CAROL PATRICIA ROBERTINE BOWEN-WELLS MD
Surgery (Surgical Oncology)
3 SHIRCLIFF WAY, SUITE 630
JACKSONVILLE, FL 32204
Duval County (904) 281-5878

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Amanda Peacock's NPI number?

The NPI number for Amanda Peacock is 1669721155. It was assigned to this individual provider in the NPPES registry on August 30, 2012.

Where is Amanda Peacock located?

Amanda Peacock practices at 3 Shircliff Way Suite 714, Jacksonville, FL 32204. The listed phone number is (904) 308-2006.

What is Amanda Peacock's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.

Is Amanda Peacock enrolled in Medicare?

Yes. Amanda Peacock is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Amanda Peacock's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Amanda Peacock reassigns Medicare benefits to 2 organizations: St Vincents Ambulatory Care Inc (Jacksonville, FL) and Physical Medicine Specialists, Inc. (Jacksonville, FL). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Amanda Peacock's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Amanda Peacock was last updated on February 11, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.