NPIMap

Individual provider Active NPI

Kirby Watson Peden, M.D.

  • Family Medicine Physician
  • Rome, GA
National Provider Identifier
1316003197
Registry record updated Mar 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
046208 Issued in GA
Practice address
420 E 2ND Ave
Suite 103
Rome, GA 30161-3209
Phone
(706) 509-3278
NPI assigned
Dec 28, 2006
Last updated
Mar 29, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 046208 GA Primary

Addresses

Primary practice location

420 E 2ND Ave
Suite 103
Rome, GA 30161-3209

Mailing address

420 E 2ND Ave
Suite 103
Rome, GA 30161-3209
Phone (706) 509-3278

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070305000452 GA Practitioner - Emergency Medicine 8628986239 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Medical College of Georgia School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Coverage LLCGroup PAC ID 3072412592, 761 clinicians
Murray Emergency Physicians, LLCGroup PAC ID 8527308840, 19 clinicians

Practice addresses (Care Compare)

501 Redmond NWRD
Rome, GA 30165-1415
Phone (706) 291-0291

707 Old Dalton Ellijay Rd
Chatsworth, GA 30705-2029
Phone (706) 695-4564

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.35 of 100Reported as group
Quality
92.65
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
96.72 of 100Reported as group
Quality
87.23
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
046208GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Hospitalists Group, LLC Current Accepting new patients
Murray Emergency Physicians, LLC CurrentSince Jan 1, 2019 Accepting new patients
Gordon Emergency Physicians, LLC CurrentSince Jul 1, 2016 Accepting new patients
Georgia Hospitalists Group, LLC CurrentSince May 13, 2017 Accepting new patients
Gordon Emergency Physicians, LLC CurrentSince Jul 1, 2016 Accepting new patients
Etowah Emergency Physicians, LLC CurrentSince Feb 1, 2017 Accepting new patients
Livingston Healthcare Past Accepting new patients
Livingston Healthcare Past Accepting new patients
Etowah Emergency Physicians, LLC PastSince Jan 26, 2020 Accepting new patients
Emergency Coverage, LLC Family Medicine Past Accepting new patients
Floyd Emergency Physicians, LLC Past Accepting new patients

Locations

1035 Red Bud Rd NE
Calhoun, GA 30701
Phone (706) 602-7800

2360 Rockmart Hwy
Cedartown, GA 30125
Phone (770) 748-2500

707 Old Dalton Ellijay Rd
Chatsworth, GA 30705
Phone (706) 517-2050

601 S 8th St
Griffin, GA 30224
Phone (770) 228-2721

304 Turner McCall Blvd SW
Rome, GA 30165
Phone (706) 506-5000

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4
  • Direct secure messaging: kpeden257667@adventhealth.direct-ci.com

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269820800000",
    "number": "1316003197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 E 2ND AVE",
            "address_2": "SUITE 103",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301613209",
            "telephone_number": "706-509-3278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 E 2ND AVE",
            "address_2": "SUITE 103",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301613209",
            "telephone_number": "706-509-3278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDEN",
        "first_name": "KIRBY",
        "middle_name": "WATSON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-28",
        "last_updated": "2010-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "046208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rome, GA

Sources for this page

Verify at the official NPI Registry.