Eastman Pediatric Clinic

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

EASTMAN PEDIATRIC CLINIC

Practice address

1223 Plaza Ave
Eastman, GA 31023-6763

Phone

(478) 374-3814

Fax

(478) 374-1478

NPI assigned

May 18, 2007

Organization subpart

No

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

Authorized official

Name

Johnny R Peeples, M.D.NPI 1457328098

Title

President-Owner

Phone

(478) 374-3814

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Johnny R Peeples, MD

  • Pediatrics Physician
  • Eastman, GA
  • NPI 1457328098
  NPD (past) Authorized official
• Ashley Nichole Butler

  • Family Nurse Practitioner
  • Eastman, GA
  • NPI 1043164882

  Pediatrics

  NPD (past)
• Aubri Rush Cranford, FNP-C

  • Family Nurse Practitioner
  • Eastman, GA
  • NPI 1598444382
  NPD (past)
• Deananne D Fordham, PAC

  • Medical Physician Assistant
  • Cochran, GA
  • NPI 1215904446
  NPD (past)
• Tori Brooke Grenade, MD

  • Internal Medicine Physician
  • Eastman, GA
  • NPI 1407233372

  Pediatrics

  NPD (past)
• Amanda Nina Little, FNP-BC

  • Family Nurse Practitioner
  • MC Rae, GA
  • NPI 1437864998
  NPD (past)
• Brittany Chandler Lord, MD

  • Pediatrics Physician
  • Eastman, GA
  • NPI 1548693021
  NPD (past)
• Steven Moore, PA

  • Physician Assistant
  • Dublin, GA
  • NPI 1962515395
  NPD (past)
• Amanda Llyn Parkerson, FNP-C

  • Family Nurse Practitioner
  • Eastman, GA
  • NPI 1700362878
  NPD (past)

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190160000000",
    "number": "1104034511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1223 PLAZA AVE",
            "city": "EASTMAN",
            "state": "GA",
            "postal_code": "310236763",
            "telephone_number": "478-374-3814",
            "fax_number": "478-374-1478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1223 PLAZA AVE",
            "city": "EASTMAN",
            "state": "GA",
            "postal_code": "310236763",
            "telephone_number": "478-374-3814",
            "fax_number": "478-374-1478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTMAN PEDIATRIC CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-18",
        "last_updated": "2007-09-19",
        "status": "A",
        "authorized_official_last_name": "PEEPLES",
        "authorized_official_first_name": "JOHNNY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT-OWNER",
        "authorized_official_telephone_number": "478-374-3814",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eastman Drugs, Inc.
• Eastman Family Dental Center LLP
• Eastman Healthcare & Rehab, LLC
• Eastman Medical Clinic LLC
• Eastman Medical Services,LLC
• Eastman Surgical Associates, LLC
• Eastman Trails of Journey LLC
• Emil Georgi MD, PC
• Naabea Enin, MD
• David Wesley Evans, L.P.C.

• Pediatrics Physician in Eastman, GA
• Providers in Eastman, GA by specialty
• Pediatrics Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.