Individual provider Active NPI

Stephen G Peters, RPH

  • Pharmacist
  • Mountain BRK, AL
National Provider Identifier
1447676259
Registry record updated Mar 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
9408 Issued in AL
Practice address
2306 Peacock LN
Mountain BRK, AL 35223-1712
Phone
(205) 616-7784
Fax
(205) 820-9153
NPI assigned
Mar 17, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 9408 AL Primary
Pharmacist 183500000X 18498 FL

Addresses

Primary practice location

2306 Peacock LN
Mountain BRK, AL 35223-1712

Mailing address

2306 Peacock LN
Mountain BRK, AL 35223-1712
Phone (205) 616-7784

Other identifiers 2

IdentifierTypeStateIssuer
18498OtherFLPHARMACIST
9408OtherALPHARMACIST

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
18498FLMDMental Health Counselor
9408ALMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1395014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395014400000",
    "number": "1447676259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2306 PEACOCK LN",
            "city": "MOUNTAIN BRK",
            "state": "AL",
            "postal_code": "352231712",
            "telephone_number": "205-616-7784",
            "fax_number": "205-820-9153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2306 PEACOCK LN",
            "city": "MOUNTAIN BRK",
            "state": "AL",
            "postal_code": "352231712",
            "telephone_number": "205-616-7784",
            "fax_number": "205-820-9153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "STEPHEN",
        "middle_name": "G",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-03-17",
        "last_updated": "2014-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AL",
            "license": "9408",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "18498",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST",
            "identifier": "18498",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST",
            "identifier": "9408",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain BRK, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.