Active NPI
Douglas Ahern Peters, MD
- Internal Medicine Physician
- Sparks, NV
National Provider Identifier
1548413503
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 2006-00519
- Practice address
- 255 Glendale Ave.
Suite 12
Sparks, NV 89431 - Phone
- (775) 356-8181
- NPI assigned
- Nov 3, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 2006-00519 | NC | Primary |
Addresses
Primary practice location
255 Glendale Ave.
Suite 12
Sparks, NV 89431
Mailing address
385 Muirfield Dr
Pawleys Island, SC 29585-6714
Phone (775) 737-3360
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5913808 | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1225670400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1530835200000",
"number": "1548413503",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "385 MUIRFIELD DR",
"city": "PAWLEYS ISLAND",
"state": "SC",
"postal_code": "295856714",
"telephone_number": "775-737-3360"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "255 GLENDALE AVE.",
"address_2": "SUITE 12",
"city": "SPARKS",
"state": "NV",
"postal_code": "89431",
"telephone_number": "775-356-8181"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERS",
"first_name": "DOUGLAS",
"middle_name": "AHERN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-11-03",
"last_updated": "2018-07-06",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NC",
"license": "2006-00519",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5913808",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sparks, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.