Peter Vernon Edblad, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

13447 Issued in GA

Practice address

655 Jesse Jewell Pkwy SE
Gainesville, GA 30501-3756

Phone

(770) 532-7092

Fax

(770) 534-8145

NPI assigned

Sep 5, 2025

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Orthopedic Surgery

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Longstreet Clinic, PCGroup PAC ID 2668465733, 140 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northeast Georgia Medical Center, Inc Hospital, Gainesville, GA, CCN 110029

Medicare enrollment (NPD)

Enrolled

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.

• The Longstreet Clinic, PC

  • Internal Medicine Physician
  • Gainesville, GA
  • NPI 1326019977

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Northeast Georgia Community Physicians LLC

  • Internal Medicine Physician
  • Gainesville, GA
  • NPI 1881583730
  Medicare reassignment
• The Longstreet Clinic PC

  • Prosthetic/Orthotic Supplier
  • Gainesville, GA
  • NPI 1053422428

  Multi-Specialty

  NPD
• Northeast Georgia Orthopaedics & Sports Medicine, LLC

  • Orthopaedic Surgery Physician
  • Hoschton, GA
  • NPI 1093725327
  NPD (past)
• Northeast Georgia Orthopaedics & Sports Medicine, LLC

  • Orthopaedic Surgery Physician
  • Gainesville, GA
  • NPI 1427079185

  Multi-Specialty

  NPD (past)

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

• Northeast Georgia Medical Center, Inc.

  • General Acute Care Hospital
  • Gainesville, GA
  • NPI 1427055821
  Care Compare affiliation

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

{
    "created_epoch": "1757030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763424000000",
    "number": "1689554032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3032 SHADES VALLEY LN",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305017438",
            "telephone_number": "763-670-5725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 JESSE JEWELL PKWY SE",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013756",
            "telephone_number": "770-532-7092",
            "fax_number": "770-534-8145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDBLAD",
        "first_name": "PETER",
        "middle_name": "VERNON",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-09-05",
        "last_updated": "2025-11-18",
        "certification_date": "2025-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": "GA",
            "license": "13447",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1689554032",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emma Lou Eaves, CCC-SLP
• Paige Elizabeth Eaves
• Zion Alexandria Eberhart
• Dawn M. Echols, L.P.C.
• Peggy Dawn Eckler, N.P.-C
• Vivien Mokuu Edi, MD
• Zantea Edouard
• Edward I Galaid, MD, LLC
• Ansu Edwards, MD
• Brian Edwards, PT, DPT

• Surgical Physician Assistant in Gainesville, GA
• Providers in Gainesville, GA by specialty
• Surgical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.