Individual provider Active NPI

Peter J. Plantes, M.D.

  • Internal Medicine Physician
  • Southlake, TX
National Provider Identifier
1194918094
Registry record updated Feb 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
19209 Issued in NC
Practice address
1414 Kensington CT
Southlake, TX 76092-9512
Phone
(817) 946-3751
NPI assigned
Aug 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 50461 WI
Internal Medicine Physician 207R00000X 35.061654 OH
Internal Medicine Physician 207R00000X 19209 NC Primary

Addresses

Primary practice location

1414 Kensington CT
Southlake, TX 76092-9512

Mailing address

1414 Kensington CT
Southlake, TX 76092-9512
Phone (817) 946-3751

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19209NCMDMental Health Counselor
35.061654OHMDInternal Medicine Physician
50461WIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
C H Wilkinson Physician Network PastSince Dec 27, 2012 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1187827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550793600000",
    "number": "1194918094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 KENSINGTON CT",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760929512",
            "telephone_number": "817-946-3751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 KENSINGTON CT",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760929512",
            "telephone_number": "817-946-3751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLANTES",
        "first_name": "PETER",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-23",
        "last_updated": "2019-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "50461",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.061654",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "19209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southlake, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2019; 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.