Keaton Peak

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

1-147512 Issued in AL

Practice address

1108 Ross Clark Cir
Dothan, AL 36301

Phone

(334) 793-8111

NPI assigned

May 7, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Nurse Practitioner

Education

University of South Alabama College of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Houston County Healthcare AuthorityGroup PAC ID 9436062296, 256 clinicians

Flowers HB Medical Services LLCGroup PAC ID 6305290990, 139 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Southeast Health Medical Center Hospital, Dothan, AL, CCN 010001
• Flowers Hospital Hospital, Dothan, AL, CCN 010055
• Medical Center Enterprise Hospital, Enterprise, AL, CCN 010049

Merit-based Incentive Payment System (MIPS)

Final score

45.86 of 100Reported as group

Quality

6.09

Improvement activities

40

Cost

81.25

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Houston County Healthcare Authority

  • Internal Medicine Physician
  • Enterprise, AL
  • NPI 1619026606
  Medicare reassignment Care Compare group NPD
• Flowers HB Medical Services LLC

  • Emergency Medicine Physician
  • Dothan, AL
  • NPI 1972283828
  Medicare reassignment Care Compare group
• Houston County Healthcare Authority

  • Internal Medicine Physician
  • Dothan, AL
  • NPI 1285783134
  NPD
• Houston County Healthcare Authority

  • Internal Medicine Physician
  • Dothan, AL
  • NPI 1538597349

  Nurse Practitioner

  NPD
• Medcore Associates, PLLC

  • Anatomic Pathology & Clinical Pathology Physician
  • Dothan, AL
  • NPI 1992524607
  NPD
• Pathology Laboratory Associates

  • Anatomic Pathology & Clinical Pathology Physician
  • Dothan, AL
  • NPI 1134190648
  NPD
• Southeast Alabama Medical Center Employee Pharmacy

  • Pharmacy
  • Dothan, AL
  • NPI 1053526368
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Houston County Healthcare Authority

  • General Acute Care Hospital
  • Dothan, AL
  • NPI 1164403861
  Care Compare affiliation
• QHG of Enterprise Inc

  • General Acute Care Hospital
  • Enterprise, AL
  • NPI 1720039712
  Care Compare affiliation
• Triad of Alabama LLC

  • General Acute Care Hospital
  • Dothan, AL
  • NPI 1801830500
  Care Compare affiliation

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

{
    "created_epoch": "1557187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568160000000",
    "number": "1467017335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1419 PEAK RD",
            "city": "WESTVILLE",
            "state": "FL",
            "postal_code": "324643072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1108 ROSS CLARK CIR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "36301",
            "telephone_number": "334-793-8111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1108 Ross Clark Cir",
            "address_purpose": "LOCATION",
            "city": "Dothan",
            "state": "AL",
            "postal_code": "36301",
            "country_code": "US",
            "telephone_number": "334-793-8111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEAK",
        "first_name": "KEATON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-07",
        "last_updated": "2019-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AL",
            "license": "1-147512",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1-147512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandy Michelle Paulson, NP
• David Payne, PH.D
• Makaila Jade Payne, RBT PENDING
• Michelle Payne
• John Charles Peacock Jr., M.D.
• Alana Dianne Pearce, DPT
• Christina Irene Pearson, CRNA
• Megan Miranda Peckham, PHARM D
• Pediatrix Medical Group of Florida Inc
• Madison Carter Pemberton, PT, DPT

• Nurse Practitioner in Dothan, AL
• Providers in Dothan, AL by specialty
• Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.