Individual provider Active NPI

Peggy McDannold, M.D.

  • Internal Medicine Physician
  • Southgate, KY
National Provider Identifier
1114960127
Registry record updated Apr 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
27527 Issued in KY
Practice address
525 Alexandria Pike
Suite 300
Southgate, KY 41071-3290
Phone
(859) 781-2210
Fax
(859) 781-0289
NPI assigned
Jun 14, 2006
Last updated
Apr 6, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 27527 KY Primary

Addresses

Primary practice location

525 Alexandria Pike
Suite 300
Southgate, KY 41071-3290

Mailing address

525 Alexandria Pike
Ste 300
Southgate, KY 41071-3290
Phone (859) 781-2210

Other identifiers 3

IdentifierTypeStateIssuer
110206742OtherKYRAILROAD MEDICARE
64275274MedicaidKY
0599115MedicaidOH

Other names 1

  • Peggy Jaeger Other name

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

OrganizationSpecialtyStatusNew patients
Diagnostic Cardiologists Inc. Past Accepting new patients
Cincinnati Health Care Group PSC Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491436800000",
    "number": "1114960127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 ALEXANDRIA PIKE",
            "address_2": "STE 300",
            "city": "SOUTHGATE",
            "state": "KY",
            "postal_code": "410713290",
            "telephone_number": "859-781-2210",
            "fax_number": "859-781-0289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 ALEXANDRIA PIKE",
            "address_2": "SUITE 300",
            "city": "SOUTHGATE",
            "state": "KY",
            "postal_code": "410713290",
            "telephone_number": "859-781-2210",
            "fax_number": "859-781-0289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDANNOLD",
        "first_name": "PEGGY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-14",
        "last_updated": "2017-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "27527",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110206742",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64275274",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0599115",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PEGGY",
            "last_name": "JAEGER",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Southgate, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.