NPIMap

Individual provider Active NPI

Michael Todd Peacock, M.D.

  • Internal Medicine Physician
  • Eastman, GA
National Provider Identifier
1487636742
Registry record updated Dec 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
040752 Issued in GA
Practice address
911 Plaza Ave
Suite C
Eastman, GA 31023-6785
Phone
(478) 374-5774
Fax
(478) 374-9112
NPI assigned
Nov 14, 2005
Last updated
Dec 12, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 040752 GA
Internal Medicine Physician 207R00000X 040752 GA Primary

Addresses

Primary practice location

911 Plaza Ave
Suite C
Eastman, GA 31023-6785

Mailing address

911 Plaza Ave
Suite C
Eastman, GA 31023-6785
Phone (478) 374-5774

Other identifiers 1

IdentifierTypeStateIssuer
00742409AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080514000403 GA Practitioner - Internal Medicine 4981773108 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Medical College of Georgia School of Medicine, 1994
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Ultra Health Providers II LLCGroup PAC ID 5395284616, 39 clinicians
Cogent Healthcare of Georgia PCGroup PAC ID 2961483607, 252 clinicians
Heart of Georgia Primary Care, LLCGroup PAC ID 3678809167, 4 clinicians

Practice addresses (Care Compare)

180 Burketts Ferry Rd
Hazlehurst, GA 31539-7132
Phone (731) 394-1145

41 N 5TH St
Glenwood, GA 30428-3701
Phone (912) 532-5102

911 Plaza Ave
Suite C
Eastman, GA 31023-6786
Phone (478) 374-5774

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ultra Health Providers II LLC CurrentSince Oct 24, 2025 Accepting new patients
Rabessler MD PC Internal Medicine CurrentSince Nov 17, 2025 Accepting new patients
M. Todd Peacock, M.D., P.C. Internal Medicine CurrentSince Aug 25, 1997 Accepting new patients
Cogent Healthcare of Georgia PC Internal Medicine CurrentSince May 6, 2023 Accepting new patients
Heart of Georgia Primary Care, LLC CurrentSince Feb 4, 2020 Accepting new patients
Selectis Warrenton LLC Past Accepting new patients
Global Eastman LLC Past Accepting new patients
LC Lumber City LLC Past Accepting new patients
Whigham Opco LLC Past Accepting new patients
SB Tybee LLC Past Accepting new patients
Dublin Health Properties LLC Past Accepting new patients
Global Abbeville, LLC Past Accepting new patients
Fitzgerald Opco LLC PastSince May 1, 2025 Accepting new patients
Am SNF LLC Past Accepting new patients
PHG Wrightsville LLC Past Accepting new patients
TN SNF LLC Past Accepting new patients
Southland Operations LLC Past Accepting new patients
GW SNF LLC Past Accepting new patients
Lake Crossing Health Center Pac LLC Past Accepting new patients
LF SNF LLC Past Accepting new patients
SL SNF, LLC Past Accepting new patients
Pinewood Healthcare & Rehab LLC Past Accepting new patients
Glenwood Opco LLC Past Accepting new patients
Westwood Pac LLC Past Accepting new patients
PW SNF LLC Past Accepting new patients
Dodge County Emergency Physicians LLC Past Accepting new patients
TB Thunderbolt LLC Past Accepting new patients
CV SNF LLC Past Accepting new patients
HZ SNF LLC Past Accepting new patients
Os Tybee LLC Past Accepting new patients
JV Jeffersonville LLC Past Accepting new patients

Locations

144 Depot St
Buchanan, GA 30113
Phone (770) 646-5512

150 E Peacock St
#A
Cochran, GA 31014
Phone (478) 271-3200

1170 Cleveland Ave
East Point, GA 30344
Phone (404) 305-3500

911 Plaza Ave
Ste C
Eastman, GA 31023
Phone (478) 231-5948

180 Burketts Ferry Rd
Hazlehurst, GA 31539
Phone (912) 293-4677

402 Bay St E
Pineview, GA 31071
Phone (229) 624-2432

1901 W Screven St
Quitman, GA 31643
Phone (229) 263-6100

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ACDAED/Endpoint/ACDAED
  • FHIR API: https://fhir4.healow.com/fhir/r4/AEADBA
  • Direct secure messaging: michael.peacock@mtpm.eclinicaldirectplus.com

Ownership & related parties

All facility ownership & control disclosures 10

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Glen Eagle Healthcare and RehabAbbeville, GA, CCN 115733 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jun 1, 2015
Jun 1, 2015
Dublinair Health & RehabDublin, GA, CCN 115356 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Feb 7, 2025
Feb 7, 2025
Wrightsville Manor Health and RehabWrightsville, GA, CCN 115406 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Feb 1, 2024
Feb 1, 2024
Eastman Healthcare & RehabEastman, GA, CCN 115622 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jun 1, 2015
Jun 1, 2015
Warrenton Health and RehabWarrenton, GA, CCN 115321 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jun 21, 2021
Jun 21, 2021
Glenwood Health and RehabilitationGlenwood, GA, CCN 115703 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 May 1, 2025
May 1, 2025
Harmony Health and RehabilitationFitzgerald, GA, CCN 115654 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 May 1, 2025
May 1, 2025
Pinewood Health and RehabilitationWhigham, GA, CCN 115607 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 May 1, 2025
May 1, 2025
Southland Healthcare and Rehab CenterDublin, GA, CCN 115376 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Apr 1, 2025
Apr 1, 2025
Remarkable HospiceDublin, GA, CCN 851580 Hospice W-2 Managing Employee Sep 21, 2023

Owned or controlled facilities with NPI records 10

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 31

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 31

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1131926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386806400000",
    "number": "1487636742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 PLAZA AVE",
            "address_2": "SUITE C",
            "city": "EASTMAN",
            "state": "GA",
            "postal_code": "310236785",
            "telephone_number": "478-374-5774",
            "fax_number": "478-374-9112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 PLAZA AVE",
            "address_2": "SUITE C",
            "city": "EASTMAN",
            "state": "GA",
            "postal_code": "310236785",
            "telephone_number": "478-374-5774",
            "fax_number": "478-374-9112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEACOCK",
        "first_name": "MICHAEL",
        "middle_name": "TODD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-14",
        "last_updated": "2013-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "040752",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "040752",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00742409A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eastman, GA

Sources for this page

Verify at the official NPI Registry.