Individual provider Active NPI

Raven Symone Peggins, CRNP

  • Family Nurse Practitioner
  • Birmingham, AL
National Provider Identifier
1366901928
Registry record updated Jun 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-150142 Issued in AL
Practice address
2000 6TH Ave S
Birmingham, AL 35233-2110
Phone
(205) 801-8587
NPI assigned
Mar 13, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 1-150142 AL
Family Nurse Practitioner 363LF0000X 1-150142 AL Primary

Addresses

Primary practice location

2000 6TH Ave S
Birmingham, AL 35233-2110

Mailing address

1020 Ashley Brook LN
Helena, AL 35080-3343
Phone (205) 413-3697

Other practice location 1

2000 6th Ave S
Birmingham, AL 35233-2110
Phone (205) 801-7654

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ravenpeggins@direct.uabmedicine.org Direct University of Alabama Hospital

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190503002003 AL Practitioner - Nurse Practitioner 4981946332 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Alabama at BirminghamGroup PAC ID 3779487970, 93 clinicians
University of Alabama Health Services Foundation, PCGroup PAC ID 1951213107, 2,784 clinicians

Practice addresses (Care Compare)

619 19TH St S
Birmingham, AL 35233-0001
Phone (205) 934-6405

619 19TH St S
Birmingham, AL 35249-1900
Phone (205) 934-4011

Hospital & facility affiliations

  • University of Alabama Hospital Hospital, Birmingham, AL, CCN 010033

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
University of Alabama Health Services Foundation, PC. CurrentSince May 14, 2019 Accepting new patients
University of Alabama at Birmingham CurrentSince Dec 24, 2023 Accepting new patients
University of Alabama at Birmingham CurrentSince Dec 24, 2023 Accepting new patients
University of Alabama at Birmingham Current Accepting new patients

Locations

619 19th St S
Birmingham, AL 35249

619 19th St S
Birmingham, AL 35233
Phone (205) 934-6405

908 20th St S
Birmingham, AL 35205
Phone (205) 934-4108

2000 6th Ave S
Birmingham, AL 35233
Phone (205) 731-9396

Interoperability endpoints

  • Direct secure messaging: ravenpeggins@direct.uabmedicine.org

Organizations & group practices 4

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 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": "1552435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687996800000",
    "number": "1366901928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 ASHLEY BROOK LN",
            "city": "HELENA",
            "state": "AL",
            "postal_code": "350803343",
            "telephone_number": "205-413-3697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 6TH AVE S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352332110",
            "telephone_number": "205-801-8587"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2000 6th Ave S",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "352332110",
            "country_code": "US",
            "telephone_number": "205-801-7654",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEGGINS",
        "first_name": "RAVEN",
        "middle_name": "SYMONE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-13",
        "last_updated": "2023-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AL",
            "license": "1-150142",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-150142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ravenpeggins@direct.uabmedicine.org",
            "affiliation": "Y",
            "affiliationName": "University of Alabama Hospital",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2000 6th Ave S",
            "city": "Birmingham",
            "state": "AL",
            "country_code": "US",
            "postal_code": "352332110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.