Keith J Peacock, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

057738 Issued in GA

Practice address

1968 Peachtree Road NW
Atlanta, GA 30309

Phone

(404) 605-2800

Fax

(404) 351-5983

NPI assigned

May 31, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Emergency Medicine

Education

Tulane University School of Medicine, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Piedmont Ed Professionals LLCGroup PAC ID 1759543176, 37 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Piedmont Hospital, Inc Hospital, Atlanta, GA, CCN 110083

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4
• Direct secure messaging: keith.peacock@westgahealth.gadirect.net

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.

• Piedmont Ed Professionals, LLC

  • Emergency Medicine Physician
  • Atlanta, GA
  • NPI 1932477429
  Medicare reassignment Care Compare group NPD
• Apollomd Group Services, LLC

  • Anesthesiology Physician
  • Griffin, GA
  • NPI 1568616860

  Emergency Medicine

  NPD (past)
• Cartersville Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Cartersville, GA
  • NPI 1346295995
  NPD (past)
• The Bortolazzo Group, LLC

  • Emergency Medicine Physician
  • Austell, GA
  • NPI 1801965082
  NPD (past)
• Trail Crossing Emergency Physicians LLC

  • Emergency Medicine Physician
  • Cartersville, GA
  • NPI 1164709937
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Piedmont Hospital, Inc

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1962461681
  Care Compare affiliation

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347321600000",
    "number": "1255378105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 COLLIER ROAD",
            "address_2": "SUITE 500",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30309",
            "telephone_number": "404-605-5516",
            "fax_number": "404-588-2601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1968 PEACHTREE ROAD NW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30309",
            "telephone_number": "404-605-2800",
            "fax_number": "404-351-5983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEACOCK",
        "first_name": "KEITH",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2012-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "057738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peachtree Women'S Clinic 2 LLC
• Peachtree Women'S Specialist 2LLC
• Peachtreeperimeter OBGYN
• Anne Peacock, MD
• Caroline Peacock, LCSW
• Peak Development Group, Inc.
• Peak Performance Chiropractic
• Eric Maurice Peak
• Sarah L Peake, PHARMD
• Brett Alan Pearce, MD

• Emergency Medicine Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Emergency Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.