Individual provider Active NPI

Peter Strogov, M.D.

  • Pediatrics Physician
  • Fort Payne, AL
National Provider Identifier
1295964682
Registry record updated Aug 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
30426 Issued in AL
Practice address
1359 Old Water Works Rd SW
Fort Payne, AL 35968-3347
Phone
(256) 997-5900
NPI assigned
Jul 7, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X 30426 AL
Pediatrics Physician 208000000X 30426 AL Primary

Addresses

Primary practice location

1359 Old Water Works Rd SW
Fort Payne, AL 35968-3347

Mailing address

1359 Old Waterworks Rd SW
Fort Payne, AL 35968-3347
Phone (256) 997-5900

Other identifiers 1

IdentifierTypeStateIssuer
139791MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
30426ALMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Springville Pediatrics LLC Pediatrics PastSince Aug 29, 2017 Accepting new patients
Trojan Pediatrics, LLC Pediatrics PastSince Jan 17, 2023 Accepting new patients
Fort Payne Pediatrics LLC Pediatrics Past Accepting new patients
Kids 1St Pediatrics, LLC Pediatrics PastSince Jul 19, 2016 Accepting new patients
Coastal Pediatrics LLC Pediatrics PastSince Mar 24, 2021 Accepting new patients
Hometown Pediatrics LLC Pediatrics PastSince Sep 10, 2020 Accepting new patients
Fort Payne Pediatrics, LLC Pediatrics PastSince Sep 4, 2013 Accepting new patients

Organizations & group practices 7

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": "1246924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660176000000",
    "number": "1295964682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1359 OLD WATERWORKS RD SW",
            "city": "FORT PAYNE",
            "state": "AL",
            "postal_code": "359683347",
            "telephone_number": "256-997-5900",
            "fax_number": "256-997-5995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1359 OLD WATER WORKS RD SW",
            "city": "FORT PAYNE",
            "state": "AL",
            "postal_code": "359683347",
            "telephone_number": "256-997-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STROGOV",
        "first_name": "PETER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-07-07",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "AL",
            "license": "30426",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AL",
            "license": "30426",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "139791",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Payne, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2022; 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.