Organization Active NPI

Peter Amos Ankoh MD PA

  • Internal Medicine Physician
  • Leesburg, FL
National Provider Identifier
1225154289
Registry record updated Sep 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME92546 Issued in FL
Legal business name
PETER AMOS ANKOH MD PA
Practice address
1107 W Dixie Ave
Leesburg, FL 34748-6311
Phone
(352) 728-2999
Fax
(352) 728-5928
NPI assigned
Mar 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2014

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

Authorized official

Name
Dr. Peter A Ankoh, MDNPI 1720044241
Title
President
Phone
(352) 728-2999

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X ME92546 FL Primary
Primary Care Clinic/Center 261QP2300X ME 92546 FL

Addresses

Primary practice location

1107 W Dixie Ave
Leesburg, FL 34748-6311

Mailing address

Post Office Box 492530
Leesburg, FL 34749-2530
Phone (352) 728-2999

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070810000202 FL Part B Supplier - Clinic/Group Practice 7416048046 Receives reassigned benefits from 1 practitioner
Practice locations: Leesburg, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D1080848Peter Amos Ankoh MD PA1107 W Dixie Ave, Leesburg, FL 34748Certificate of waiverMar 3, 2028

National Provider Directory

National Provider Directory

Locations

709 Physicians Ct
Leesburg, FL 34748
Phone (352) 728-2999

1107 W Dixie Ave
Leesburg, FL 34748
Phone (352) 728-2999

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": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410393600000",
    "number": "1225154289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "POST OFFICE BOX 492530",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347492530",
            "telephone_number": "352-728-2999",
            "fax_number": "352-460-0050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 W DIXIE AVE",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347486311",
            "telephone_number": "352-728-2999",
            "fax_number": "352-728-5928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETER AMOS ANKOH MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2014-09-11",
        "status": "A",
        "authorized_official_last_name": "ANKOH",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "352-728-2999",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME92546",
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "FL",
            "license": "ME 92546",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.