Individual provider Active NPI

Roosevelt Peebles Jr., M.D

  • Plastic Surgery Physician
  • Nashville, TN
National Provider Identifier
1073591731
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
MD024686 Issued in TN
Practice address
1916 Patterson St
Suite 205
Nashville, TN 37203-2192
Phone
(615) 320-9300
Fax
(615) 320-3065
NPI assigned
Jan 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X MD024686 TN Primary

Addresses

Primary practice location

1916 Patterson St
Suite 205
Nashville, TN 37203-2192

Mailing address

2014 Clifton Ave
Nashville, TN 37203-1910
Phone (615) 320-9300

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
I20120326000038 TN Practitioner - Plastic and Reconstructive Surgery 6608036959

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD024686TNMDPlastic Surgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1136332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1073591731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2014 CLIFTON AVE",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372031910",
            "telephone_number": "615-320-9300",
            "fax_number": "615-320-3065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1916 PATTERSON ST",
            "address_2": "SUITE 205",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372032192",
            "telephone_number": "615-320-9300",
            "fax_number": "615-320-3065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEEBLES",
        "first_name": "ROOSEVELT",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-04",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "TN",
            "license": "MD024686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

Verify at the official NPI Registry.