Organization Active NPI

Peeples Health and Wellness

  • Family Nurse Practitioner
  • Pooler, GA
National Provider Identifier
1194416982
Registry record updated Jul 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
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

Updated by the provider on Jul 19, 2023

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)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 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 Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231003003653 GA Part B Supplier - Clinic/Group Practice 9537513973 Receives reassigned benefits from 1 practitioner
Practice locations: Pooler, GA

National Provider Directory

National Provider Directory

Locations

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.

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.

Verify at the official NPI Registry.