NPIMap

Individual provider Active NPI

Ashley Roxanne Peterson, DO

  • Family Medicine Physician
  • Aiken, SC
National Provider Identifier
1346700796
Registry record updated Jan 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
87776 Issued in SC
Practice address
209 Abbeville Ave NW
Aiken, SC 29801-3923
Phone
(803) 306-1433
Fax
(803) 632-1209
NPI assigned
Mar 21, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2024

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 87776 SC Primary

Addresses

Primary practice location

209 Abbeville Ave NW
Aiken, SC 29801-3923

Mailing address

86 Wren St
Barnwell, SC 29812-1529
Phone (803) 259-5762

Other practice location 1

1022 Calhoun St # 201
Columbia, SC 29201-2406
Phone (803) 610-4199

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20220805001379 SC Practitioner - Family Practice 9234511395 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Low Country Health Care System Inc 33 clinicians

Practice addresses (Care Compare)

333 Revolutionary TRL
Fairfax, SC 29827-7109
Phone (803) 632-2533

Hospital & facility affiliations

  • Aiken Regional Medical Center Hospital, Aiken, SC, CCN 420082

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
87776SCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Low Country Health Care System, Inc. CurrentSince Jan 2, 2024 Accepting new patients
Dedicated South Carolina Holding, LLC CurrentSince Sep 1, 2022 Accepting new patients
Low Country Health Care System, Inc Current Accepting new patients
Low Country Health Care System, Inc CurrentSince Jan 2, 2024 Accepting new patients
Low Country Health Care System, Inc. Current Accepting new patients
Low Country Health Care System, Inc Past Accepting new patients

Locations

1395 NW 167th St
Miami Gardens, FL 33169
Phone (305) 831-4760

209 Abbeville Ave NW
Aiken, SC 29801
Phone (803) 306-1433

526 North St
Bamberg, SC 29003
Phone (803) 245-2433

185 McGee St
Bamberg, SC 29003
Phone (803) 245-4327

86 Wren St
Barnwell, SC 29812
Phone (803) 259-5762

124 Wren St
Barnwell, SC 29812
Phone (803) 254-3278

10706 Marlboro Ave
Barnwell, SC 29812
Phone (803) 259-7337

130 Baker St N
Blackville, SC 29817
Phone (803) 284-1045

1022 Calhoun St
#201
Columbia, SC 29201
Phone (803) 610-4199

333 Revolutionary Trl
Fairfax, SC 29827
Phone (803) 632-2533

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1553126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704153600000",
    "number": "1346700796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "86 WREN ST",
            "city": "BARNWELL",
            "state": "SC",
            "postal_code": "298121529",
            "telephone_number": "803-259-5762",
            "fax_number": "803-259-3250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 ABBEVILLE AVE NW",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298013923",
            "telephone_number": "803-306-1433",
            "fax_number": "803-632-1209"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1022 Calhoun St # 201",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292012406",
            "country_code": "US",
            "telephone_number": "803-610-4199",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "ASHLEY",
        "middle_name": "ROXANNE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-21",
        "last_updated": "2024-01-02",
        "certification_date": "2024-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "87776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aiken, SC

Sources for this page

Verify at the official NPI Registry.