Nicholas Patrick Peters, PA
Individual provider Active NPI Physician Assistant · Kannapolis, NC
NPI 1407598428 · NPPES record last updated Dec 18, 2023
Key facts
- NPI
- 1407598428
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 0010-12604 (NC)
- Practice address
- 4949 Professional Park Dr
Ste 101
Kannapolis, NC 28081-8637 - Phone
- (704) 938-6521
- NPI assigned
- Apr 11, 2022
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 11
Hospital & facility affiliations 6
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Privia Medical Group, LLC
Practice addresses (Care Compare)
1120 1St Colonial Rd
Suite 100
Virginia Beach, VA 23454-2418
Phone (757) 481-2333
8644 Sudley Rd
Suite 220
Manassas, VA 20110-4425
Phone (571) 366-8845
950 N Glebe Rd
Suite 700
Arlington, VA 22203-4173
Hospital & facility affiliations
- Sentara Home Care Services-Virginia Beach
- Sentara Virginia Beach General Hospital
- Sentara Princess Anne Hospital
- Sentara Norfolk General Hospital
- Sentara Leigh Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NC, VA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221117000038 | NC | Practitioner - Physician Assistant | 0547638827 | Reassigns benefits to 1 organization |
| I20240402003601 | VA | Practitioner - Physician Assistant | 0547638827 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Privia Medical Group, LLC | Current |
Accepting new patients | |
| Carolinas Physicians Network Inc | Current |
Accepting new patients | |
| Carolinas Physicians Network Inc | Current |
Accepting new patients | |
| Privia Medical Group, LLC | Current |
Accepting new patients | |
| Nova Physician Wellness Center PLLC | Past | Accepting new patients |
Locations
270 Copperfield Blvd NE
Ste 102
Concord, NC 28025
Phone (704) 721-2060
4949 Professional Park Dr
Ste 101
Kannapolis, NC 28081
Phone (704) 938-6521
950 N Glebe Rd
Ste 700
Arlington, VA 22203
Phone (484) 228-1065
8644 Sudley Rd
#220
Manassas, VA 20110
1120 First Colonial Rd
Ste 100
Virginia Beach, VA 23454
Phone (757) 481-2333
Interoperability endpoints
- https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
- npeters1066178@carolinashealthcaresystem.direct-ci.com
- nicholas.peters.1@8042.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0010-12604 | NC | Yes |
Addresses
Primary practice location
4949 Professional Park Dr
Ste 101
Kannapolis, NC 28081-8637
Mailing address
PO Box 19305
Charlotte, NC 28219-9305
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | npeters1066178@CarolinasHealthcareSystem.direct-ci.com | Atrium Health | |
| CONNECT URL | https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | ABILITY Network |
Other providers in Kannapolis, NC
- Jackie Payne-McGee
- Pearce and Partners Therapy Solutions, PLLC
- Kelly Ryan Pearce
- James Matthew Peckinpaugh
- Kaylee Jade Pena
- Jessica Lanier Petersen
- Beth Pfister
- Douglas Phares
- Wayne Phillip
- Phytcare LLC
All providers in Kannapolis, NC · Physician Assistant in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 18, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.