Barbara T Peacock, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

R085963 Issued in GA

Practice address

101 Harris Industrial Blvd
Ste C
Vidalia, GA 30474-8852

Phone

(912) 537-1014

NPI assigned

Apr 10, 2006

Sex

Female

Sole proprietor

No

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.

• St Josephs Candler Urgent Care Centers LLC

  • Urgent Care Clinic/Center
  • Savannah, GA
  • NPI 1922580133

  GA

  Medicare reassignment Care Compare group NPD
• Statesboro OB-GYN Specialists, PC

  • Specialist
  • Statesboro, GA
  • NPI 1841348521

  GA

  Medicare reassignment NPD
• St Josephs Candler Urgent Care Centers LLC

  • Urgent Care Clinic/Center
  • Bluffton, SC
  • NPI 1902468697
  Care Compare group NPD

Specialty

Nurse Practitioner

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Josephs Candler Urgent Care Centers LLC 38 clinicians

Practice addresses (Care Compare)

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/8182/brand/1/csg/1/fhir/r4

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 16, 2022.

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652659200000",
    "number": "1477516680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 407",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304750407",
            "telephone_number": "912-537-4986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 HARRIS INDUSTRIAL BLVD",
            "address_2": "STE C",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304748852",
            "telephone_number": "912-537-1014"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1096 Bermuda Run",
            "address_purpose": "LOCATION",
            "city": "Statesboro",
            "state": "GA",
            "postal_code": "304580858",
            "country_code": "US",
            "telephone_number": "912-871-5150",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEACOCK",
        "first_name": "BARBARA",
        "middle_name": "T",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-10",
        "last_updated": "2022-05-16",
        "certification_date": "2022-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "R085963",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000845115B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rohit Govindbhai Patel, RPH
• Paul Anderson Family Strong Center, Inc.
• Paul Anderson Youth Home, Inc.
• Paul Joseph Giles, M.D., LLC
• James R Payne, PA C
• Brendan Darby Pearsall, PHARMD
• John Peery, RPH
• Peterson Dermatology, P.C.
• Letty Revell Peterson, M.D.
• Phillips Drugs, Inc

• All providers in Vidalia, GA
• Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2022; 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.