Peacock Primary Care, LLC
NPI 1578333639ActiveOrganization· Nurse Practitioner, Family· Shreveport, LA
Nurse Practitioner, Family in Shreveport, Louisiana, registered in NPPES in January 2024. The authorized official on file is Brandy Peacock, MSN, APRN, FNP-BS, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1578333639 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jan 8, 2024 |
| Last updated in NPPES | Jan 8, 2024 |
| Certified by provider | Jan 8, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Family Primary | 363LF0000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (LA) |
|---|
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