Individual provider Active NPI

Corey D Peeples, FNP

  • Family Nurse Practitioner
  • Pooler, GA
National Provider Identifier
1467951780
Registry record updated Jun 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN216997 Issued in GA
Practice address
408 US Highway 80 SW
Pooler, GA 31322-2541
Phone
(912) 295-2133
NPI assigned
Feb 2, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN216997 GA Primary

Addresses

Primary practice location

408 US Highway 80 SW
Pooler, GA 31322-2541

Mailing address

5629 Hwy 21 S
Rincon, GA 31326-9416
Phone (912) 295-2133

Other identifiers 1

IdentifierTypeStateIssuer
RN216997OtherGAGEORGIA NP LICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20180628001706 GA Practitioner - Nurse Practitioner 2062768369 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

408 US Hwy 80 SW
Pooler, GA 31322-2541
Phone (912) 508-6414

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN216997GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Peeples Health and Wellness Family CurrentSince May 15, 2023 Accepting new patients
Medical Wellness Center of Georgia, LLC PastSince Sep 18, 2018 Accepting new patients

Locations

408 US Highway 80 SW
Pooler, GA 31322
Phone (912) 503-0516

Interoperability endpoints

  • Direct secure messaging: corey.peeples@3163.securemail.prognocis.com

Organizations & group practices 3

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 1

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": "1517529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686096000000",
    "number": "1467951780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5629 HWY 21 S",
            "city": "RINCON",
            "state": "GA",
            "postal_code": "313269416",
            "telephone_number": "912-295-2133",
            "fax_number": "912-295-5924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 US HIGHWAY 80 SW",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313222541",
            "telephone_number": "912-295-2133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEEPLES",
        "first_name": "COREY",
        "middle_name": "D",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-02",
        "last_updated": "2023-06-07",
        "certification_date": "2023-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN216997",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEORGIA NP LICENSE NUMBER",
            "identifier": "RN216997",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pooler, GA

Sources for this page

Verify at the official NPI Registry.