Individual provider Active NPI

Fred Neal Peebles, M.D.

  • Surgery Physician
  • Powell, TN
National Provider Identifier
1225145279
Registry record updated Jul 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD6687 Issued in TN
Practice address
7557 Dannaher Way
Suite 110
Powell, TN 37849
Phone
(865) 938-8121
Fax
(865) 212-5561
NPI assigned
Aug 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD6687 TN Primary

Addresses

Primary practice location

7557 Dannaher Way
Suite 110
Powell, TN 37849

Mailing address

Dept 888067
Knoxville, TN 37995-8067
Phone (865) 588-8838

Other identifiers 1

IdentifierTypeStateIssuer
3172263MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20080729000149 TN Practitioner - General Surgery 4486726817

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD6687TNMDSurgery Physician
6687TNMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Surgical Associates, PLLC Surgery Past Accepting new patients
Premier Surgical Associates, PLLC Surgery PastSince Sep 29, 2006 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71045

Organizations & group practices 2

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": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215734400000",
    "number": "1225145279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT 888067",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379958067",
            "telephone_number": "865-588-8838",
            "fax_number": "865-584-7712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7557 DANNAHER WAY",
            "address_2": "SUITE 110",
            "city": "POWELL",
            "state": "TN",
            "postal_code": "37849",
            "telephone_number": "865-938-8121",
            "fax_number": "865-212-5561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEEBLES",
        "first_name": "FRED",
        "middle_name": "NEAL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2008-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TN",
            "license": "MD6687",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3172263",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Powell, TN

Sources for this page

Verify at the official NPI Registry.