Individual provider Active NPI

Peter Kevin Meyers, M.D.

  • Gastroenterology Physician
  • Tyler, TX
National Provider Identifier
1437162716
Registry record updated Oct 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
G9987 Issued in TX
Practice address
1720 South Beckham Ave
Tyler, TX 75701
Phone
(903) 595-5101
Fax
(903) 597-2314
NPI assigned
Aug 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X G9987 TX Primary

Addresses

Primary practice location

1720 South Beckham Ave
Tyler, TX 75701

Mailing address

1720 South Beckham Ave
Tyler, TX 75701
Phone (903) 595-5101

Other identifiers 1

IdentifierTypeStateIssuer
129811906MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160426000397 GA Practitioner - Gastroenterology 1658368725 Reassigns benefits to 2 organizations
I20161102000901 WI Practitioner - Gastroenterology 1658368725 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Phoebe Physician Group, Inc CurrentSince Mar 9, 2016 Accepting new patients
Hopkins County Hospital District Current Accepting new patients
MCHS Hospitals Inc CurrentSince Mar 1, 2018 Accepting new patients
Hospital Authority of Valdosta and Lowndes County Georgia CurrentSince Jan 1, 2020 Accepting new patients
Hospital Authority of Valdosta and Lowndes County Georgia Current Accepting new patients
Marshfield Clinic Inc CurrentSince Oct 24, 2016 Accepting new patients
Hospital Authority of Valdosta and Lowndes County Georgia Current Accepting new patients
Hospital Authority of Valdosta and Lowndes County, Georgia CurrentSince Jan 1, 2020 Accepting new patients
MCHS Hospitals Inc CurrentSince Mar 1, 2018 Accepting new patients

Locations

500 W 3rd Ave
Ste 101
Albany, GA 31701
Phone (229) 312-5802

2002 Palmyra Rd
Ste 201
Albany, GA 31701
Phone (229) 312-5802

151 Mayo St
Ste B
Americus, GA 31709
Phone (229) 928-2900

2501 N Patterson St
Valdosta, GA 31602
Phone (229) 259-4139

115 Airport Rd
Sulphur Springs, TX 75482
Phone (903) 439-4052

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

1000 Starr Ave
Eau Claire, WI 54703
Phone (715) 858-4850

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

Interoperability endpoints

  • Direct secure messaging: peterm@direct.hcmh.md

Organizations & group practices 9

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": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381708800000",
    "number": "1437162716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 SOUTH BECKHAM AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "75701",
            "telephone_number": "903-595-5101",
            "fax_number": "903-597-2314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 SOUTH BECKHAM AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "75701",
            "telephone_number": "903-595-5101",
            "fax_number": "903-597-2314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEYERS",
        "first_name": "PETER",
        "middle_name": "KEVIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2013-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TX",
            "license": "G9987",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "129811906",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.