Peter S Jerome MD PLLC

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

Legal business name

PETER S JEROME MD PLLC

Practice address

350 Bowden LN
Coldspring, TX 77331-9240

Phone

(469) 492-9802

NPI assigned

Apr 5, 2024

Last updated

Apr 5, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Peter S Jerome, MD

Title

Owner

Phone

(469) 492-9802

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• PETER S JEROME MD PLLC Former legal business name

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

{
    "created_epoch": "1712275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712275200000",
    "number": "1174375760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 BOWDEN LN",
            "city": "COLDSPRING",
            "state": "TX",
            "postal_code": "773319240",
            "telephone_number": "469-492-9802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 BOWDEN LN",
            "city": "COLDSPRING",
            "state": "TX",
            "postal_code": "773319240",
            "telephone_number": "469-492-9802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETER S JEROME MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-05",
        "last_updated": "2024-04-05",
        "certification_date": "2024-04-05",
        "status": "A",
        "authorized_official_last_name": "JEROME",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "469-492-9802",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "393948003",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PETER S JEROME MD PLLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Tri Minh Le, MD
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• Philip R. Wisiackas, M.D., P.a.
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• Janet Kristine Sanve, M.ED
• Senior Citizens of San Jacinto County

• Pulmonary Disease Physician in Coldspring, TX
• Providers in Coldspring, TX by specialty
• Pulmonary Disease Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2024; 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.