Individual provider Active NPI

Jimmy Peebles, DO

  • Emergency Medicine Physician
  • Augusta, GA
National Provider Identifier
1366478281
Registry record updated Mar 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
32451 Issued in GA
Practice address
1350 Walton Way
Augusta, GA 30901-2612
Phone
(904) 805-1300
Fax
(904) 805-1302
NPI assigned
Jun 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 32451 GA Primary

Addresses

Primary practice location

1350 Walton Way
Augusta, GA 30901-2612

Mailing address

PO Box 532780
Atlanta, GA 30353-2780
Phone (904) 805-1300

Other identifiers 4

IdentifierTypeStateIssuer
005735OtherGABLUE CROSS
930037620OtherGARAILROAD MEDICARE
G32451OtherSCSOUTH CAROLINA MEDICAID
000409076JMedicaidGA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031119000281 GA Practitioner - Emergency Medicine 4082528393 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
032451GAMDPharmacist
32451GAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Em-I Medical Services, LLC Emergency Medicine CurrentSince Jun 15, 2012 Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients
Georgia Em-I Medical Services, PC Emergency Medicine CurrentSince Jun 15, 2012 Accepting new patients
Au Medical Associates Inc CurrentSince Jan 1, 2013 Accepting new patients
Au Medical Associates Emergency Medicine Billing Services, LLC Emergency Medicine CurrentSince Sep 1, 2015 Accepting new patients
Wellstar Medical Group, LLC CurrentSince Nov 9, 2024 Accepting new patients
Georgia Em-I Medical Services. LLC Emergency Medicine Current Accepting new patients
Au Medical Associates Inc CurrentSince Jan 1, 2013 Accepting new patients
Cyrus Emergency Physicians, LLC Emergency Medicine Past Accepting new patients
Sterling Emergency Services of the Southeast Inc Emergency Medicine Past Accepting new patients
Augusta Physicians Group, LLC Emergency Medicine PastSince Jan 26, 2020 Accepting new patients
Csra Emergency Physicians Emergency Medicine Past Accepting new patients

Locations

3651 Wheeler Rd
Augusta, GA 30909
Phone (706) 651-3232

1499 Walton Way
Ste 1400
Augusta, GA 30901
Phone (706) 721-4951

1120 15th St
Bldg O107
Augusta, GA 30912

1350 Walton Way
Augusta, GA 30901
Phone (706) 722-9011

2260 Wrightsboro Rd
Augusta, GA 30904
Phone (706) 481-7000

1120 15th St
Augusta, GA 30912
Phone (706) 721-3873

5126 Hospital Dr NE
Covington, GA 30014
Phone (770) 385-4340

200 Industrial Blvd
Dublin, GA 31021
Phone (478) 274-3865

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 12

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": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205712000000",
    "number": "1366478281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 532780",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303532780",
            "telephone_number": "904-805-1300",
            "fax_number": "904-805-1302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 WALTON WAY",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309012612",
            "telephone_number": "904-805-1300",
            "fax_number": "904-805-1302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEEBLES",
        "first_name": "JIMMY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2008-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "32451",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "005735",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "930037620",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUTH CAROLINA MEDICAID",
            "identifier": "G32451",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000409076J",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

Verify at the official NPI Registry.