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Deactivated NPI 1508197864 Deactivated / Inactive NPI Male Practitioner

Cory G Peppard , CRNA

Licensed Practical Nurse • Kennewick, WA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Cory Peppard has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date January 26, 2010
NPI Deactivation Date August 16, 2023
Total Practice Duration ~13 Years of Practice (2010 – 2023)

Professional Overview & Biography Verified Profile Summary

Cory Peppard, CRNA was a registered Licensed Practical Nurse practicing in Kennewick, WA. Throughout an active medical career spanning 13 years, Cory Peppard provided care at the practice location at 900 S AUBURN ST until profile deactivation on 2023-08-16.

Historical Medicare Part B clinical services included anesthesia for procedure on small and large bowel using an endoscope, anesthesia for procedure on large bowel using an endoscope, anesthesia for open procedure on bones of lower leg, ankle and foot. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

900 S Auburn St

Kennewick, WA 993365621

Telephone 5097371878
Fax 5097371879
Associated Practice Facility / Clinic
🏢 Three Rivers Anesthesia Llc Facility NPI 1841248275

Specialty Benchmarks & Practice Insights

Comparative analytics for Licensed Practical Nurse in Kennewick, WA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
11 Specialists

Practicing in Kennewick, WA (1730 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
86.5% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2023)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
00813 Anesthesia for procedure on small and large bowel using an endoscope
15 15 $1189.00 $162.74
00811 Anesthesia for procedure on large bowel using an endoscope
13 13 $936.92 $122.17
01480 Anesthesia for open procedure on bones of lower leg, ankle and foot
11 11 $1199.55 $163.76

Medical Specialties & State Licenses

Licensed Practical Nurse Primary Specialty

NUCC Taxonomy Code: 164W00000X

State License WA AP60128232

An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

4 Associated Practitioners
NPI 1538351176

Doctor of Medicine (M.D.)

Deborah Dell , ARNP

Registered Nurse - Psychiatric/Mental Health

NPI 1568547198

Advanced Registered Nurse Practitioner

Matthew Palmblad , ARNP

Nurse Practitioner - Family

NPI 1790055077

Advanced Registered Nurse Practitioner

NPI 1922075597

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events
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NPI Profile Deactivated August 16, 2023

Record deactivated on August 16, 2023

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Medical Taxonomy / Specialty Registered (Primary Specialty) May 14, 2019

Nurse Anesthetist, Certified Registered (License #AP60128232 in WA)

NPI Profile Active January 26, 2010

NPI status registered as active in NPPES database

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Updated Practice Location January 26, 2010

Registered at 900 S AUBURN ST, KENNEWICK, WA 993365621 (Tel: 5097371878)

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Updated Business Mailing Address January 26, 2010

Registered at 900 S AUBURN ST, KENNEWICK, WA 993365621 (Tel: 5097371878)

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Provider Name / Credentials Updated January 26, 2010

Recorded as CORY PEPPARD, CRNA

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Medical Taxonomy / Specialty Registered (Primary Specialty) January 26, 2010

Licensed Practical Nurse (License #AP60128232 in WA)

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Initial NPI Registration & Enumeration January 26, 2010

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1508197864
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 26, 2010
Last Update: January 26, 2010
Deactivation Date: August 16, 2023

Mailing Address

900 S Auburn St

Kennewick, WA 993365621

Phone: 5097371878

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.