MR. JEFFREY FRANK PEACOCK PA-C
NPI 1972753689
Physician Assistant - Medical in Fort Campbell, KY

Q: What is Jeffrey Peacock's NPI number?

The NPI number for Jeffrey Peacock is 1972753689. It was assigned to this individual provider in the NPPES registry on September 30, 2008.

Q: What is Jeffrey Peacock's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Q: When was this NPI record last updated?

The NPPES record for Jeffrey Peacock was last updated on September 30, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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 September 30, 2008PECOS Enrolled

650 JOEL DR, FT. CAMPBELL, KY, FORT CAMPBELL, KY 42223(270) 798-8106(279) 956-0180 Get Directions Write a Review

NPPES record last updated: September 30, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Mr. Jeffrey Frank Peacock Pa-c NPPES

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

MR. JEFFREY FRANK PEACOCK PA-C (NPI 1972753689) is an individual medical provider in Fort Campbell, Kentucky, licensed in Tennessee (1084990) and active in the NPI registry since September 2008. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1972753689

Entity TypeIndividualMale

Primary Taxonomy363AM0700X

Provider Legal NameMR. JEFFREY FRANK PEACOCKCredential: PA-C

Location Address650 JOEL DR, FT. CAMPBELL, KYFort Campbell, KY 42223-5318

Mailing Address650 Joel Dr, Ft. Campbell BachFort Campbell, KY 42223-5318 · (270) 798-8106 · Fax (279) 956-0180

Phone(270) 798-8106

Fax(279) 956-0180

Sole ProprietorNo

Enumeration DateSeptember 30, 2008

✔ NPI 1972753689 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

License✔ Licensed in TN · 1084990

Also ListedPhysician AssistantTaxonomy 363A00000X · License 1084990 (TX)

650 JOEL DR, Fort Campbell, KY 42223

Open in Google Maps ↗

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. Jeffrey Frank Peacock Pa-c 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 20

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

LISA RENEE CORDELL RN

Registered Nurse