BRAD LEE PECK DPM NPI 1730760307

NPI Information

  • NPI: 1730760307
  • Provider Name: BRAD LEE PECK, DPM
  • Classification: Podiatrist - 213ES0103X
  • Specialization: Foot & Ankle Surgery
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 6070 S FORT APACHE RD STE 100
    LAS VEGAS, NV
    ZIP 89148
  • Phone: (702) 803-5534

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NPI Details

Brad Lee Peck, DPM is a foot and ankle surgery podiatrist in Las Vegas, NV with 5 years of experience. Brad Lee Peck, DPM NPI is 1730760307. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: DES MOINES UNIVERSITY OF OSTEOPATHIC MEDICINE AND HEALTH SCIENCES
Graduation Year:2021

The provider's business location address is:

6070 S FORT APACHE RD STE 100
LAS VEGAS, NV
ZIP 89148-615
Phone: (702) 803-5534

The NPI 1730760307 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 4/15/2021 and was last updated on 4/25/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1390200000XStudent in an Organized Health Care Education/Training ProgramNORTH CAROLINANo
2213ES0103XPodiatristFoot & Ankle Surgery2104NEVADAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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