Robert M Peters Jr., PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA499 Issued in KY

Practice address

851 Ireland Loop, Ces, Iach
Ft. Knox, KY 40121

Phone

(502) 624-9503

Fax

(502) 624-9747

NPI assigned

Oct 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053493882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 CEDAR HILL DR",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427018695",
            "telephone_number": "502-624-9503",
            "fax_number": "502-624-9747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "851 IRELAND LOOP, CES, IACH",
            "city": "FT. KNOX",
            "state": "KY",
            "postal_code": "40121",
            "telephone_number": "502-624-9503",
            "fax_number": "502-624-9747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "ROBERT",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John J. Parsley, PSYD
• Gina Michelle Pawley-Whitley, LCSW
• Cynthia Lorraine Pearson, NURSE PRACTITIONER
• Andres Perez, MD
• Kelly Marie Pesis, PA
• Emmanuel Asamoah Prah, MPAS, PA-C
• Tami M Prince, M.D.
• John W Rauch, D.D.S.02
• Dayna Ray, APRN
• Tammy Jo Ray, MSN, APRN

• Physician Assistant in Ft. Knox, KY
• Providers in Ft. Knox, KY by specialty
• Physician Assistant in Kentucky

• 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.

Verify at the official NPI Registry.