Individual provider Active NPI

Peter Ankrom, DO

  • Emergency Medicine Physician
  • Rome, GA
National Provider Identifier
1013930478
Registry record updated Oct 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
2255 Issued in TN
Practice address
420 E 2ND Ave
Suite 103
Rome, GA 30161-3224
Phone
(706) 509-3278
Fax
(706) 509-4608
NPI assigned
Jul 26, 2006
Last updated
Oct 19, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 041256 GA
Internal Medicine Physician 207R00000X 041256 GA
Emergency Medicine Physician 207P00000X 2255 TN Primary

Addresses

Primary practice location

420 E 2ND Ave
Suite 103
Rome, GA 30161-3224

Mailing address

304 Turner McCall Blvd SW
Rome, GA 30165-5621
Phone (706) 509-5000

Other identifiers 3

IdentifierTypeStateIssuer
000702798JMedicaidGA
P00428756OtherRAILROAD MEDICARE
00702798BMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110609000716 TN Practitioner - Emergency MedicinePractitioner - Internal Medicine 9931094042 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
App of Tennessee Ed, PLLC Emergency Medicine CurrentSince Sep 20, 2017 Accepting new patients
Signify Health Medical Associates, PLLC CurrentSince Nov 18, 2022 Accepting new patients
Emergency Coverage Services, PC Past Accepting new patients
Tennessee Em-I Medical Services PC Past Accepting new patients
Rosebud Indian Health Service Past Accepting new patients
Dublin Emergency Physicians LLC Emergency Medicine Past Accepting new patients
Sterling Emergency Services of the Southeast Inc Emergency Medicine Past Accepting new patients

Locations

300 Montvue Rd
Knoxville, TN 37919
Phone (818) 613-6769

1411 W Baddour Pkwy
Lebanon, TN 37087
Phone (615) 443-2500

907 Lamar Alexander Pkwy
Maryville, TN 37804
Phone (865) 766-8818

100 Northcrest Dr
Springfield, TN 37172
Phone (615) 384-1531

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Interoperability endpoints

  • Direct secure messaging: pankrom670561@direct.vumc.org
  • Direct secure messaging: pcankrom@yourcarecommunity.org

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476835200000",
    "number": "1013930478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 TURNER MCCALL BLVD SW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301655621",
            "telephone_number": "706-509-5000",
            "fax_number": "706-509-4608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 E 2ND AVE",
            "address_2": "SUITE 103",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301613224",
            "telephone_number": "706-509-3278",
            "fax_number": "706-509-4608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANKROM",
        "first_name": "PETER",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2016-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "041256",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "041256",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "2255",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000702798J",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00428756",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00702798B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rome, GA

Sources for this page

Verify at the official NPI Registry.