Active NPI
Peeples Health and Wellness
- Family Nurse Practitioner
- Pooler, GA
National Provider Identifier
1194416982
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- Legal business name
- PEEPLES HEALTH AND WELLNESS
- Practice address
- 408 US Highway 80 SW
Pooler, GA 31322-2541 - Phone
- (912) 508-6414
- NPI assigned
- May 15, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jenny Newcomb
- Title
- Contracting
- Phone
- (631) 736-4064
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | Primary |
Addresses
Primary practice location
408 US Highway 80 SW
Pooler, GA 31322-2541
Mailing address
761 Middle Country Rd
Selden, NY 11784-2550
Phone (631) 736-4064
Other names 1
- PEEPLES HEALTH AND WELLNESS
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
408 US Highway 80 SW
Pooler, GA 31322
Phone (912) 503-0516
408 US Highway 80 SW
Ste 501
Pooler, GA 31322
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Nurse Practitioner
- Pooler, GA
- NPI 1467951780
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1684108800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1689724800000",
"number": "1194416982",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "761 MIDDLE COUNTRY RD",
"city": "SELDEN",
"state": "NY",
"postal_code": "117842550",
"telephone_number": "631-736-4064"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "408 US HIGHWAY 80 SW",
"city": "POOLER",
"state": "GA",
"postal_code": "313222541",
"telephone_number": "912-508-6414"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PEEPLES HEALTH AND WELLNESS",
"organizational_subpart": "NO",
"enumeration_date": "2023-05-15",
"last_updated": "2023-07-19",
"certification_date": "2023-07-19",
"status": "A",
"authorized_official_last_name": "NEWCOMB",
"authorized_official_first_name": "JENNY",
"authorized_official_title_or_position": "CONTRACTING",
"authorized_official_telephone_number": "631-736-4064"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner, Family",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "PEEPLES HEALTH AND WELLNESS",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "PEEPLES HEALTH AND WELLNESS",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Pooler, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.