Justus Turner Peters, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

BP20024815 Issued in TX

Practice address

2800 Village Rd Ste 108
Granbury, TX 76049-4194

Phone

(817) 573-0444

Fax

(817) 573-1611

NPI assigned

Oct 22, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Complete Emergency Care Southlake LLC

  • Emergency Care Clinic/Center
  • Southlake, TX
  • NPI 1174937668
  NPD (past)
• Michael L. Davis, M.D. P.a.

  • Family Medicine Physician
  • Glen Rose, TX
  • NPI 1194985325
  NPD (past)

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

{
    "created_epoch": "1193011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386115200000",
    "number": "1285823641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3129",
            "city": "GLEN ROSE",
            "state": "TX",
            "postal_code": "760433129",
            "telephone_number": "254-897-2202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 VILLAGE RD STE 108",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760494194",
            "telephone_number": "817-573-0444",
            "fax_number": "817-573-1611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "JUSTUS",
        "middle_name": "TURNER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-22",
        "last_updated": "2013-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "BP20024815",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "N1064",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200720506",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pecan Valley MHMR Region
• Pecan Valley MHMR Region
• Pecan Valley MHMR Region
• Peter K Krone MD PA
• Peter K Krone MD, PA
• Steven Warren Peterson, D.O.
• Courtney Phillips, DC
• Katharine Phillips
• Physical Management Professionals
• Brett Picciotti, D.O.

• Family Medicine Physician in Granbury, TX
• Providers in Granbury, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2013; 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.