Active NPI
John Vernon Peet, MD
- Family Medicine Physician
- Conroe, TX
National Provider Identifier
1083702930
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- D7241
- Practice address
- 4015 I 45 N
Conroe, TX 77304-4901 - Phone
- (936) 760-7864
- NPI assigned
- Oct 10, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | D7241 | TX | Primary |
Addresses
Primary practice location
4015 I 45 N
Conroe, TX 77304-4901
Mailing address
4015 I 45 N
Conroe, TX 77304-4901
Phone (936) 760-7864
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 099343802 | Medicaid | TX |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sadler Clinic Association | 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1268179200000",
"number": "1083702930",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4015 I 45 N",
"city": "CONROE",
"state": "TX",
"postal_code": "773044901",
"telephone_number": "936-760-7864"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4015 I 45 N",
"city": "CONROE",
"state": "TX",
"postal_code": "773044901",
"telephone_number": "936-760-7864"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEET",
"first_name": "JOHN",
"middle_name": "VERNON",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-10",
"last_updated": "2010-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TX",
"license": "D7241",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "099343802",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Conroe, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.