Individual provider Active NPI

Mhroos Faik Barak Peters, M.D.

  • Family Medicine Physician
  • Beaver Dam, KY
National Provider Identifier
1083734123
Registry record updated Oct 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
59935 Issued in KY
Practice address
1213 N Main St
Beaver Dam, KY 42320-8955
Phone
(270) 274-4771
Fax
(270) 274-4884
NPI assigned
Mar 30, 2007
Last updated
Oct 10, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101267619 VA
Family Medicine Physician 207Q00000X 59935 KY Primary
Internal Medicine Physician 207R00000X 249349 NY
Hospitalist Physician 208M00000X 0101267619 VA

Addresses

Primary practice location

1213 N Main St
Beaver Dam, KY 42320-8955

Mailing address

1021 W Oakland Ave Ste 310
Johnson City, TN 37604-2192
Phone (423) 302-6565

Other practice location 1

1201 Pleasant Valley Rd
Owensboro, KY 42303-9811
Phone (270) 417-4700

Other practice location 2

440 Hopkinsville St
Greenville, KY 42345-1124
Phone (270) 338-8000

Other practice location 3

245 Medical Park Dr Fl 2
Marion, VA 24354-1100
Phone (276) 378-3300

Other practice location 4

58 Carroll Street
Rm 2037
Lebanon, VA 24266-4510
Phone (276) 883-8000

Other practice location 5

16000 Johnston Memorial Dr Fl 4
Abingdon, VA 24211-7664
Phone (276) 258-1000

Other practice location 6

100 Port Washington Blvd.
Saint Francis Hospitalists
Roslyn, NY 11576-1347
Phone (516) 562-6385

Other identifiers 2

IdentifierTypeStateIssuer
03037390MedicaidNY
7101011770MedicaidKY

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mpeters128439@direct.owensborohealth.org
Direct Messaging Address mpeters128439@direct.owensborohealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, TN, KY3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20191219000459 VA Practitioner - HospitalistPractitioner - Internal Medicine 6709959281 Reassigns benefits to 2 organizations
I20230711004161 TN Practitioner - Hospitalist 6709959281 Reassigns benefits to 1 organization
I20241206003499 KY Practitioner - Internal Medicine 6709959281 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Family Practice, Internal Medicine
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1201 Pleasant Valley Rd
Owensboro, KY 42303-9811

1213 N Main St
Beaver Dam, KY 42320-8955
Phone (270) 274-4771

2211 Mayfair Dr
Owensboro, KY 42301-4569

910 Wallace Ave
Leitchfield, KY 42754-2414
Phone (270) 259-9491

PO Box
Owensboro, KY 42304-3229

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
59935KYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmont Medical Associates Inc Family Medicine CurrentSince Dec 1, 2023 Accepting new patients
Owensboro Health Medical Group Inc Current Accepting new patients
Wellmont Medical Associates, Inc. CurrentSince Jul 1, 2023 Accepting new patients
Owensboro Health Medical Group Inc Internal Medicine CurrentSince Oct 21, 2024 Accepting new patients
Blue Ridge Medical Management Corporation Current Accepting new patients
Blue Ridge Medical Management Internal Medicine CurrentSince Oct 11, 2019 Accepting new patients
Owensboro Health Medical Group Inc Family Medicine CurrentSince Oct 21, 2024 Accepting new patients
Wellmont Medical Associates Inc Family Medicine CurrentSince Jul 1, 2023 Accepting new patients
Blue Ridge Medical Management Corporation Family Medicine CurrentSince Oct 11, 2019 Accepting new patients
Owensboro Health Medical Group, Inc Family Medicine Past Accepting new patients
Blue Ridge Medical Management Corporation Past Accepting new patients
St Francis Hospital United States Catholic Conference Past Accepting new patients
Cogent Medical Care PC Family Medicine Past Accepting new patients

Locations

1213 N Main St
Beaver Dam, KY 42320
Phone (270) 274-4771

440 Hopkinsville St
Greenville, KY 42345
Phone (270) 338-8000

1201 Pleasant Valley Rd
Owensboro, KY 42303
Phone (270) 417-2000

2211 Mayfair Dr
Ste 101
Owensboro, KY 42301
Phone (270) 688-1352

2211 Mayfair Dr
Ste 102
Owensboro, KY 42301
Phone (270) 688-1351

1021 W Oakland Ave
Ste 310
Johnson City, TN 37604
Phone (423) 302-6565

111 W Stone Dr
Ste 100
Kingsport, TN 37660
Phone (423) 247-5197

16000 Johnston Memorial Dr
Abingdon, VA 24211
Phone (276) 258-1000

16000 Johnston Memorial Dr
Fl 4
Abingdon, VA 24211
Phone (276) 258-1000

323 Falls Dr NW
Abingdon, VA 24210
Phone (276) 628-2612

391 Falls Dr NW
Abingdon, VA 24210
Phone (276) 628-4406

1990 Holton Ave E
Big Stone Gap, VA 24219
Phone (276) 523-3111

245 Medical Park Dr
Fl 2
Marion, VA 24354
Phone (276) 378-1000

Interoperability endpoints

  • Direct secure messaging: mpeters128439@direct.owensborohealth.org

Organizations & group practices 13

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 13

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760054400000",
    "number": "1083734123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 W OAKLAND AVE STE 310",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042192",
            "telephone_number": "423-302-6565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1213 N MAIN ST",
            "city": "BEAVER DAM",
            "state": "KY",
            "postal_code": "423208955",
            "telephone_number": "270-274-4771",
            "fax_number": "270-274-4884"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1201 Pleasant Valley Rd",
            "address_purpose": "LOCATION",
            "city": "Owensboro",
            "state": "KY",
            "postal_code": "423039811",
            "country_code": "US",
            "telephone_number": "270-417-4700",
            "fax_number": "270-417-4709",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "440 Hopkinsville St",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "KY",
            "postal_code": "423451124",
            "country_code": "US",
            "telephone_number": "270-338-8000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "245 Medical Park Dr Fl 2",
            "address_purpose": "LOCATION",
            "city": "Marion",
            "state": "VA",
            "postal_code": "243541100",
            "country_code": "US",
            "telephone_number": "276-378-3300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "58 Carroll Street",
            "address_2": "Rm 2037",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "VA",
            "postal_code": "242664510",
            "country_code": "US",
            "telephone_number": "276-883-8000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16000 Johnston Memorial Dr Fl 4",
            "address_purpose": "LOCATION",
            "city": "Abingdon",
            "state": "VA",
            "postal_code": "242117664",
            "country_code": "US",
            "telephone_number": "276-258-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Port Washington Blvd.",
            "address_2": "Saint Francis Hospitalists",
            "address_purpose": "LOCATION",
            "city": "Roslyn",
            "state": "NY",
            "postal_code": "115761347",
            "country_code": "US",
            "telephone_number": "516-562-6385",
            "fax_number": "516-562-6300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAIK BARAK PETERS",
        "first_name": "MHROOS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-30",
        "last_updated": "2025-10-10",
        "certification_date": "2025-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101267619",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "59935",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "249349",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "VA",
            "license": "0101267619",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03037390",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7101011770",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mpeters128439@direct.owensborohealth.org",
            "affiliation": "N",
            "address_1": "1201 Pleasant Valley Rd",
            "city": "Owensboro",
            "state": "KY",
            "country_code": "US",
            "postal_code": "423039811",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mpeters128439@direct.owensborohealth.org",
            "affiliation": "N",
            "address_1": "1213 N Main St",
            "city": "Beaver Dam",
            "state": "KY",
            "country_code": "US",
            "postal_code": "423208955",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Beaver Dam, KY

Sources for this page

Verify at the official NPI Registry.