George Worthy Pegram III

Primary specialty

OptometristTaxonomy code 152W00000X

License

0601001900 Issued in VA

Practice address

801 Poindexter St Ste 115
Chesapeake, VA 23324-2358

Phone

(757) 545-3930

Fax

(757) 545-0193

NPI assigned

Dec 5, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Southern College of Optometry, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pegram and Cornetta P L CGroup PAC ID 3678590064, 2 clinicians

Edinburgh Eye Care LLCGroup PAC ID 4880999234, 4 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Elice Genier O'Hara, OD

  • Optometrist
  • Chesapeake, VA
  • NPI 1316514250
  Medicare reassignment

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.

• Edinburgh Eye Care LLC

  • Optometrist
  • Chesapeake, VA
  • NPI 1821462680
  Medicare reassignment Care Compare group NPD
• Pegram & Cornetta P L C

  • Optometrist
  • Norfolk, VA
  • NPI 1770558561
  Medicare reassignment Care Compare group NPD
• George W. Pegram III

  • Optometrist
  • Chesapeake, VA
  • NPI 1720154057
  NPD (past) Authorized official
• George W. Pegram III, O.D.

  • Optometrist
  • Chesapeake, VA
  • NPI 1083009039
  NPD (past) Authorized official
• Platinum Eye Care LLC

  • Optometrist
  • Virginia Beach, VA
  • NPI 1790837854
  NPD (past)

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

{
    "created_epoch": "1133740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347494400000",
    "number": "1740264662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 POINDEXTER ST STE 115",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233242358",
            "telephone_number": "757-545-3930",
            "fax_number": "757-545-0193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 POINDEXTER ST STE 115",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233242358",
            "telephone_number": "757-545-3930",
            "fax_number": "757-545-0193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEGRAM",
        "first_name": "GEORGE",
        "middle_name": "WORTHY",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-05",
        "last_updated": "2012-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0601001900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED VISION CARE",
            "identifier": "940935",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAVIS VISION",
            "identifier": "5452",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009238182",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Denita Peele-Whickum, PMHNP
• Vernita Newby Peeples, M.D.
• Peering Works LLC
• Elizabeth Blake Peery, M.S.
• Arkitia Sherrie Pegram-Crawley, LPC
• Anthony Pellegrino, MD
• Nicole Renee Pelon
• Joy Pappas Pena
• Peniel-Treasure Care Services LLC
• Peninsula Cancer Institute LLC

• Optometrist in Chesapeake, VA
• Providers in Chesapeake, VA by specialty
• Optometrist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2012; 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.