Individual provider Active NPI

Melinda H Peterlin, MD

  • Pediatrics Physician
  • St Simons Island, GA
National Provider Identifier
1194712505
Registry record updated Dec 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
072916 Issued in GA
Practice address
7000 Wellness Way Ste 7230
St Simons Island, GA 31522-2286
Phone
(912) 634-2795
Fax
(912) 638-5636
NPI assigned
Sep 30, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 44728 020 WI
Pediatrics Physician 208000000X 072916 GA Primary

Addresses

Primary practice location

7000 Wellness Way Ste 7230
St Simons Island, GA 31522-2286

Mailing address

7000 Wellness Way Ste 7230
St Simons Island, GA 31522-2286
Phone (912) 634-2795

Other identifiers 1

IdentifierTypeStateIssuer
34231500MedicaidWI

Other names 1

  • Melinda Hough Peterlin Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20250407001192 GA Practitioner - Pediatric Medicine 3375630395 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
072916GAMDPediatrics Physician
44728 020WIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Community Health Services Inc CurrentSince Dec 5, 2024 Accepting new patients
Coastal Community Health Services, Inc. CurrentSince Dec 5, 2024 Accepting new patients
Southeast Georgia Health System, Inc. Past Accepting new patients
Cooperative Healthcare Services Inc Pediatrics Past Accepting new patients

Locations

3300 4th St
Brunswick, GA 31520
Phone (912) 267-0884

106 Shoppers Way
Ste 101
Brunswick, GA 31525
Phone (912) 275-8208

100 Professional Center Dr
Brunswick, GA 31525

7000 Wellness Way
Ste 7230
St Simons Island, GA 31522
Phone (912) 466-5840

Organizations & group practices 4

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": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765929600000",
    "number": "1194712505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7000 WELLNESS WAY STE 7230",
            "city": "ST SIMONS ISLAND",
            "state": "GA",
            "postal_code": "315222286",
            "telephone_number": "912-634-2795",
            "fax_number": "912-638-5636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7000 WELLNESS WAY STE 7230",
            "city": "ST SIMONS ISLAND",
            "state": "GA",
            "postal_code": "315222286",
            "telephone_number": "912-634-2795",
            "fax_number": "912-638-5636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERLIN",
        "first_name": "MELINDA",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-30",
        "last_updated": "2025-12-17",
        "certification_date": "2025-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "44728 020",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "072916",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34231500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELINDA",
            "last_name": "PETERLIN",
            "middle_name": "HOUGH",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in St Simons Island, GA

Sources for this page

Verify at the official NPI Registry.