MR. BRYAN JAMES PEACOCK L.P.C.
NPI 1780819797
Counselor - Professional in Wauwatosa, WI

Active since May 19, 2009PECOS Enrolled
11904 W NORTH AVE, SUITE # 110, WAUWATOSA, WI 53226(414) 248-4347 Get Directions Write a Review

NPPES record last updated: May 19, 2009. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Mr. Bryan James Peacock L.p.c. NPPES

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

MR. BRYAN JAMES PEACOCK L.P.C. (NPI 1780819797) is an individual professional provider in Wauwatosa, Wisconsin, licensed in Wisconsin (3957-125) and active in the NPI registry since May 2009. He is enrolled in Medicare PECOS and is a graduate of Other (2004).

NPPES Registry Identity

NPI1780819797
Entity TypeIndividualMale
Primary Taxonomy101YP2500X
Provider Legal NameMR. BRYAN JAMES PEACOCKCredential: L.P.C.
Location Address11904 W NORTH AVE, SUITE # 110Wauwatosa, WI 53226-2062
Mailing AddressN67w24937 Stonegate Ct, #203Sussex, WI 53089-2585 · (414) 840-7247
Sole ProprietorNo
Medical School CMSOtherGraduated 2004
Enumeration DateMay 19, 2009
NPI 1780819797 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License Licensed in WI · 3957-125
11904 W NORTH AVE, Wauwatosa, WI 53226

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Mr. Bryan James Peacock L.p.c. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3678081908
PECOS Enrollment IDI20250806001838
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 13

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

Physical Therapist
11904 W NORTH AVE, SUITE 100
WAUWATOSA, WI 53226
Dentist (General Practice)
11904 W NORTH AVE
WAUWATOSA, WI 53226
Community/Behavioral Health
11904 W NORTH AVE, SUITE 110
WAUWATOSA, WI 53226
Physical Therapist
11904 W NORTH AVE, STE 100
WAUWATOSA, WI 53226
Dentist (General Practice)
11904 W NORTH AVE
WAUWATOSA, WI 53226
Physical Therapy Assistant
11904 W NORTH AVE, SUITE 100
WAUWATOSA, WI 53226
Physical Therapist
11904 W NORTH AVE, SUITE 100
WAUWATOSA, WI 53226
Counselor (Professional)
11904 W NORTH AVE, SUITE 110
WAUWATOSA, WI 53226

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 Bryan Peacock's NPI number?

The NPI number for Bryan Peacock is 1780819797. It was assigned to this individual provider in the NPPES registry on May 19, 2009.

Where is Bryan Peacock located?

Bryan Peacock practices at 11904 W North Ave Suite # 110, Wauwatosa, WI 53226. The listed phone number is (414) 248-4347.

What is Bryan Peacock's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Bryan Peacock enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Bryan Peacock was last updated on May 19, 2009. NPI Profile syncs with the weekly NPPES data releases published by CMS.