Individual provider Active NPI

Peter Frederick Farmer, M.D.

  • Pediatric Gastroenterology Physician
  • Raleigh, NC
National Provider Identifier
1205299708
Registry record updated Aug 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
2023-01264 Issued in NC
Practice address
23 Sunnybrook Rd
Raleigh, NC 27610-1855
Phone
(919) 235-6435
NPI assigned
Apr 1, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 35.138849 OH
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X 35.138849 OH
Pediatric Gastroenterology Physician 2080P0206X 2023-01264 NC Primary

Addresses

Primary practice location

23 Sunnybrook Rd
Raleigh, NC 27610-1855

Mailing address

PO Box 603949
Charlotte, NC 28260-3949
Phone (877) 498-4490

Other practice location 1

4363 All Seasons Dr Ste 100
Hilliard, OH 43026-2050
Phone (614) 355-5900

Other practice location 2

100 Colemans Xing
Marysville, OH 43040-7080
Phone (937) 578-7600

Other practice location 3

700 Childrens Dr
Columbus, OH 43205-2664
Phone (614) 722-4329

Other practice location 4

433 N Cleveland Ave
Westerville, OH 43082-8095
Phone (614) 355-8300

Other practice location 5

7901 Diley Rd Ste 150
Canal Winchester, OH 43110-9613
Phone (614) 355-9050

Other practice location 6

6435 E Broad St
Columbus, OH 43213-1507
Phone (614) 355-8100

Other practice location 7

7450 Hospital Dr Ste 100
Dublin, OH 43016-8364
Phone (614) 355-7000

Other identifiers 2

IdentifierTypeStateIssuer
1205299708MedicaidNC
0468059MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, OH, NC3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20190807002973 VA Practitioner - Pediatric Medicine 5092042473 Reassigns benefits to 1 organization
I20211208002311 OH Practitioner - Emergency MedicinePractitioner - Pediatric Medicine 5092042473 Reassigns benefits to 1 organization
I20230831001676 NC Practitioner - Pediatric Medicine 5092042473 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.138849OHMDPediatric Emergency Medicine (Pediatrics) Physician
35.139496OHMDPediatric Emergency Medicine (Pediatrics) Physician
2023-01264NCMDPediatric Gastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wakemed Specialists Group, LLC Pediatric Gastroenterology CurrentSince Jul 31, 2023 Accepting new patients
Wakemed Specialists Group LLC CurrentSince Jul 31, 2023 Accepting new patients
Pediatric Academic Association, Inc. Pediatrics CurrentSince Nov 30, 2021 Accepting new patients
Childrens Specialty Group PLLC Pediatrics CurrentSince Jul 1, 2019 Accepting new patients
Wakemed Specialists Group, LLC Current Accepting new patients
Nationwide Children'S Hospital Past Accepting new patients

Locations

104 Medspring Dr
Clayton, NC 27520
Phone (919) 235-6422

3000 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-7000

23 Sunnybrook Rd
Raleigh, NC 27610
Phone (919) 322-4800

700 Childrens Dr
Columbus, OH 43205
Phone (614) 722-4411

6435 E Broad St
Columbus, OH 43213
Phone (614) 355-8100

Dept L289
Columbus, OH 43260

7450 Hospital Dr
Ste 100
Dublin, OH 43016
Phone (614) 355-7000

433 N Cleveland Ave
Westerville, OH 43082
Phone (614) 355-8300

601 Childrens Ln
Norfolk, VA 23507
Phone (757) 668-7272

Interoperability endpoints

  • Direct secure messaging: pfarmer455389@directhisp.wakemed.org

Organizations & group practices 6

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": "1459468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692835200000",
    "number": "1205299708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 603949",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282603949",
            "telephone_number": "877-498-4490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 SUNNYBROOK RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276101855",
            "telephone_number": "919-235-6435"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4363 All Seasons Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Hilliard",
            "state": "OH",
            "postal_code": "430262050",
            "country_code": "US",
            "telephone_number": "614-355-5900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Colemans Xing",
            "address_purpose": "LOCATION",
            "city": "Marysville",
            "state": "OH",
            "postal_code": "430407080",
            "country_code": "US",
            "telephone_number": "937-578-7600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "700 Childrens Dr",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432052664",
            "country_code": "US",
            "telephone_number": "614-722-4329",
            "fax_number": "614-722-4380",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "433 N Cleveland Ave",
            "address_purpose": "LOCATION",
            "city": "Westerville",
            "state": "OH",
            "postal_code": "430828095",
            "country_code": "US",
            "telephone_number": "614-355-8300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7901 Diley Rd Ste 150",
            "address_purpose": "LOCATION",
            "city": "Canal Winchester",
            "state": "OH",
            "postal_code": "431109613",
            "country_code": "US",
            "telephone_number": "614-355-9050",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6435 E Broad St",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432131507",
            "country_code": "US",
            "telephone_number": "614-355-8100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7450 Hospital Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Dublin",
            "state": "OH",
            "postal_code": "430168364",
            "country_code": "US",
            "telephone_number": "614-355-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FARMER",
        "first_name": "PETER",
        "middle_name": "FREDERICK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-01",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35.138849",
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "OH",
            "license": "35.138849",
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "NC",
            "license": "2023-01264",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1205299708",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0468059",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.