Active NPI
Gregory Tyrone Peters, MPT
- Physical Therapist
- Wadesboro, NC
National Provider Identifier
1326252149
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- P11670
- Practice address
- 877 McRae Ave
Wadesboro, NC 28170-6491 - Phone
- (704) 694-9604
- NPI assigned
- May 10, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 20679 | MD | |
| Physical Therapist | 225100000X | P11670 | NC | Primary |
Addresses
Primary practice location
877 McRae Ave
Wadesboro, NC 28170-6491
Mailing address
877 McRae Ave
Wadesboro, NC 28170-6491
Phone (704) 694-9604
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20679 | MD | MD | Pharmacist |
| P11670 | NC | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1227052800000",
"number": "1326252149",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "877 MCRAE AVE",
"city": "WADESBORO",
"state": "NC",
"postal_code": "281706491",
"telephone_number": "704-694-9604"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "877 MCRAE AVE",
"city": "WADESBORO",
"state": "NC",
"postal_code": "281706491",
"telephone_number": "704-694-9604"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERS",
"first_name": "GREGORY",
"middle_name": "TYRONE",
"name_prefix": "Mr.",
"credential": "MPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-10",
"last_updated": "2008-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MD",
"license": "20679",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "P11670",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wadesboro, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.