Jonathan Holmes Peeples, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

075118 Issued in GA

Practice address

1112 Daniels St BSMT Suite
Vancouver, WA 98660-2954

Phone

(323) 522-2218

NPI assigned

Apr 29, 2013

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, NC, AR, OK4 enrollments

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 4

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Animo Sano Psychiatry PLLC

  • Psychiatry Physician
  • Durham, NC
  • NPI 1568043537

  AR, GA, OK

  Medicare reassignment NPD
• Affect Therapeutics Inc

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Charlottesville, VA
  • NPI 1104402064
  NPD (past)
• Affect Therapeutics, Inc.

  • Adult Mental Health Clinic/Center
  • Albuquerque, NM
  • NPI 1942948351
  NPD (past)

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

{
    "created_epoch": "1367193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660176000000",
    "number": "1679918015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2522 W JULIANN CT",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992085686",
            "telephone_number": "601-259-9766",
            "fax_number": "770-644-1586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1112 DANIELS ST BSMT SUITE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986602954",
            "telephone_number": "323-522-2218"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2522 W Juliann Ct",
            "address_purpose": "LOCATION",
            "city": "Spokane",
            "state": "WA",
            "postal_code": "992085686",
            "country_code": "US",
            "telephone_number": "601-259-9766",
            "fax_number": "770-644-1586",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEEPLES",
        "first_name": "JONATHAN",
        "middle_name": "HOLMES",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-29",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "075118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Gerald Pederson, RPH
• Pediatric Services of America, LLC
• Pediatric Services of America, LLC
• Pediatric Services of America, LLC
• Melissa Jayne Peede
• Katelyn Peer
• Kyra Peerenboom
• Kathryn Laurene Peil
• Sotheary Pel, PHARMACIST
• Misty Geneine Pelagalli, RC

• Psychiatry Physician in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Psychiatry Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.