Active NPI
Peter Albert Modrow, M.D.
- Anesthesiology Physician
- Raleigh, NC
National Provider Identifier
1043369820
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 14727
- Practice address
- 312 Meeting House Cir
Raleigh, NC 27615-3131 - Phone
- (919) 870-8833
- Fax
- (919) 870-8833
- NPI assigned
- Jan 9, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 14727 | NC | Primary |
Addresses
Primary practice location
312 Meeting House Cir
Raleigh, NC 27615-3131
Mailing address
312 Meeting House Cir
Raleigh, NC 27615-3131
Phone (919) 870-8833
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14727 | NC | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vidant Medical Group LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Multi-Specialty Clinic/Center
- Greenville, NC
- NPI 1477648731
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168300800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1043369820",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "312 MEETING HOUSE CIR",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276153131",
"telephone_number": "919-870-8833",
"fax_number": "919-870-8833"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "312 MEETING HOUSE CIR",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276153131",
"telephone_number": "919-870-8833",
"fax_number": "919-870-8833"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MODROW",
"first_name": "PETER",
"middle_name": "ALBERT",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "NC",
"license": "14727",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.