Charles Leroy Peacock, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

RN182133 CRNA Issued in GA

Practice address

1000 Medical Center Blvd
Lawrenceville, GA 30045-7694

Phone

(678) 442-4321

NPI assigned

Feb 26, 2007

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

Enrolled in LA

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Galleria Anesthesia Associates, LLCGroup PAC ID 6507261740, 36 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Avala Hospital, Covington, LA, CCN 190267

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• Galleria Anesthesia Associates, LLC

  • Anesthesiology Physician
  • Metairie, LA
  • NPI 1962966796
  Medicare reassignment Care Compare group NPD
• Anesthesiology Group Associates Inc

  • Specialist
  • Baton Rouge, LA
  • NPI 1255399598
  Medicare reassignment NPD
• Childrens Hospital Anesthesia Corporation

  • Anesthesiology Physician
  • New Orleans, LA
  • NPI 1649362740
  Medicare reassignment NPD
• Ochsner Clinic LLC

  • General Practice Physician
  • New Orleans, LA
  • NPI 1538151428
  Medicare reassignment NPD
• University Medical Center Management Corporation

  • Family Medicine Physician
  • New Orleans, LA
  • NPI 1083655567
  Medicare reassignment NPD
• Youngs Professional Services LLC

  • Certified Registered Nurse Anesthetist
  • New Iberia, LA
  • NPI 1922178599

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Ochsner Clinic LLC

  • Registered Dietitian
  • Covington, LA
  • NPI 1013747039
  NPD
• The Capital City Anesthesia Group, LLC

  • Anesthesiology Physician
  • Baton Rouge, LA
  • NPI 1245282466

  Nurse Anesthetist, Certified Registered

  NPD
• University Medical Center Management Corporation

  • Psychiatric Hospital Unit
  • New Orleans, LA
  • NPI 1144261728
  NPD
• Gwinnett Anesthesia Service PC

  • Anesthesiology Physician
  • Lawrenceville, GA
  • NPI 1528015930
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Fairway Medical Center, LLC

  • General Acute Care Hospital
  • Covington, LA
  • NPI 1851487086
  Care Compare affiliation

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063548964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 CONNELL LN",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300446123",
            "telephone_number": "770-736-5173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 MEDICAL CENTER BLVD",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300457694",
            "telephone_number": "678-442-4321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEACOCK",
        "first_name": "CHARLES",
        "middle_name": "LEROY",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "RN182133 CRNA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peach State Pediatric Therapy Inc.
• Peach State Smiles
• Peachtree MRI LLC
• Aurora J. Peacock, MD
• Belinda J Peacock, NP
• Heather Peak, RN
• Billy S Pealock, D.M.D
• Jennifer Charlene Pean-Winston, FNP-C
• David Edward Pearson, DMD
• Dominique Daielle Peart, CRNA

• Certified Registered Nurse Anesthetist in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Certified Registered Nurse Anesthetist in Georgia

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.