Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ethan William Peck

Individual provider Physician Assistant · NPI 1912878455

Ethan William Peck is a Physician Assistant in Nashville, Tennessee. Qualified in 2025, 1 year ago. Registered with an NPI since 2025.

Years since qualifying
1
In the registry since
2025

Practice location Address checks out

865 Bellevue Rd Apt J14
Nashville, TN 37221-2774
Phone: (586) 531-0491
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1912878455
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedSeptember 17, 2025
Last updated in NPPESSeptember 17, 2025
Certification dateSeptember 16, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated

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