Charles Alonzo Peters Jr., MD / PHD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

071613 Issued in GA

Practice address

609 E Lamar St
Americus, GA 31709-3737

Phone

(229) 924-8636

Fax

(229) 924-8786

NPI assigned

Apr 9, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

Practice roles

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.

• Sweetgrass Pediatrics

  • Pediatrics Physician
  • North Charleston, SC
  • NPI 1437168135
  NPD (past)
• Tri-County Pediatrics LLC

  • Pediatrics Physician
  • Rock Hill, SC
  • NPI 1366403792
  NPD (past)

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

{
    "created_epoch": "1397001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403049600000",
    "number": "1497174239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 E LAMAR ST",
            "city": "AMERICUS",
            "state": "GA",
            "postal_code": "317093737",
            "telephone_number": "229-924-8636",
            "fax_number": "229-924-8786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 E LAMAR ST",
            "city": "AMERICUS",
            "state": "GA",
            "postal_code": "317093737",
            "telephone_number": "229-924-8636",
            "fax_number": "229-924-8786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "CHARLES",
        "middle_name": "ALONZO",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD / PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-09",
        "last_updated": "2014-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "071613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Perfect Care, Inc
• Latavia Perkins
• Perry Wellness Center
• Perry Wellness Center, Inc.
• Lori Perry
• Jamya Peters
• Tabitha Phelps-Riggian, RN
• Phoebe Sumter Medical Center Inc
• Phoebe Sumter Medical Center, Inc.
• Phoebe Sumter Medical Center, Inc.

• Pediatrics Physician in Americus, GA
• Providers in Americus, GA by specialty
• Pediatrics Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.