Individual provider Active NPI

Peter G Lawrence, M.D.

  • Urology Physician
  • Jackson, TN
National Provider Identifier
1124001219
Registry record updated Mar 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
MD0000038436 Issued in TN
Practice address
28 Medical Center Dr
Jackson, TN 38301-3947
Phone
(731) 427-9971
Fax
(731) 424-2052
NPI assigned
Nov 22, 2005
Last updated
Mar 27, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X MD0000038436 TN Primary

Addresses

Primary practice location

28 Medical Center Dr
Jackson, TN 38301-3947

Mailing address

PO Box 1446
Dyersburg, TN 38025-1446
Phone (731) 427-9971

Other identifiers 4

IdentifierTypeStateIssuer
3892671MedicaidTN
4083742OtherTNBLUE CROSS BLUE SHIELD
07646597OtherTNAETNA
8805391OtherTNCIGNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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

Enrollment IDStateProvider typePAC IDDetails
I20040616001414 TN Practitioner - Urology 4587648597 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of Louisville School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jackson Urological Associates, P.C.Group PAC ID 5395728935, 5 clinicians

Practice addresses (Care Compare)

28 Medical Ctr Dr
Jackson, TN 38301-3947
Phone (731) 427-9971

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD0000038436TNMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson Urological Associates, P.C. Urology CurrentSince Jul 1, 2004 Accepting new patients

Locations

28 Medical Center Dr
Jackson, TN 38301
Phone (731) 427-9971

Interoperability endpoints

  • Direct secure messaging: peter.lawrence.p1@direct.cpc.nextgenshare.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332806400000",
    "number": "1124001219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1446",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "380251446",
            "telephone_number": "731-427-9971",
            "fax_number": "731-424-2052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 MEDICAL CENTER DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013947",
            "telephone_number": "731-427-9971",
            "fax_number": "731-424-2052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWRENCE",
        "first_name": "PETER",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-22",
        "last_updated": "2012-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "TN",
            "license": "MD0000038436",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3892671",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "4083742",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "07646597",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "8805391",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

Verify at the official NPI Registry.