James Glenn Peters, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

08788 Issued in MS

Practice address

14724 Highway 15 N
Louisville, MS 39339-6318

Phone

(662) 773-7500

NPI assigned

Sep 12, 2005

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Choctaw Regional Medical Center

  dba Louisville Medical Clinic

  • Rural Health Clinic/Center
  • Louisville, MS
  • NPI 1538555347

  W-2 Managing Employee

  CMS ownership

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.

• Choctaw Regional Medical Center

  dba Choctaw Medical Clinic of Ackerman

  • Family Medicine Physician
  • Ackerman, MS
  • NPI 1235547878
  Medicare reassignment NPD
• Winston County Medical Foundation

  dba Winston Medical Center

  • General Acute Care Hospital
  • Louisville, MS
  • NPI 1316078108
  Medicare reassignment NPD
• Winston Medical Clinic LLC

  dba Winston Medical Clinic Noxapater

  • Rural Health Clinic/Center
  • Noxapater, MS
  • NPI 1588091714
  NPD (past)

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

{
    "created_epoch": "1126483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583798400000",
    "number": "1114912680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8613 MS HIGHWAY 12",
            "city": "ACKERMAN",
            "state": "MS",
            "postal_code": "397358917",
            "telephone_number": "662-285-9460",
            "fax_number": "662-285-9324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14724 HIGHWAY 15 N",
            "city": "LOUISVILLE",
            "state": "MS",
            "postal_code": "393396318",
            "telephone_number": "662-773-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "JAMES",
        "middle_name": "GLENN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-12",
        "last_updated": "2020-03-10",
        "certification_date": "2020-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "08788",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00017300",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Roger L Nunez, MD
• Raymond John Orgler, M.D.
• Jennifer Palmer, FNP-C
• Kenneth E Peres, MD
• Emily Davis Perkins, F.N.P.
• Michelle J Plante, LPC, CCAP, NCC
• Leda S Porter, MS
• Beverly Jan Randle, F.N.P.
• Valerie L Ray, MS
• RCG Mississippi, Inc. (RCG Louisville)

• Family Medicine Physician in Louisville, MS
• Providers in Louisville, MS by specialty
• Family Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.