Gordon J Peltier, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

015808 Issued in GA

Practice address

1121 Johnson Ferry Rd
Suite 100
Marietta, GA 30068-5425

Phone

(770) 509-1025

NPI assigned

Jun 5, 2006

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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Aga, LLC

  • Gastroenterology Physician
  • Atlanta, GA
  • NPI 1124064118
  NPD (past)

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603843200000",
    "number": "1508805573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1955 LAKE PARK DR",
            "address_2": "STE. 250",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "30080",
            "telephone_number": "678-223-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 JOHNSON FERRY RD",
            "address_2": "SUITE 100",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300685425",
            "telephone_number": "770-509-1025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELTIER",
        "first_name": "GORDON",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "015808",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00255802B",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "NFMUC_Cumming@Northside.gwaydirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Messaging",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Edge",
            "address_1": "1121 Johnson Ferry Rd",
            "address_2": "Suite 100",
            "city": "Marietta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300685425",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kishwar Peiris, LPC
• Jenna Lee Peixoto, PT, DPT
• Soni Pelino, DPT
• Taylor Smith Pell, PT, DPT
• Amanda Y Pellerito, PA
• Jeffrey Carl Pence, MD
• Rae K. Pencek, OTR/L
• Denis Pendrick
• Sam Qingshuang Peng, M.D.
• Yin Peng

• Emergency Medicine Physician in Marietta, GA
• Providers in Marietta, GA by specialty
• Emergency Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.