Diane Peterman, MD
Individual provider Active NPI Family Medicine Physician · Eatonton, GA
NPI 1740310044 · NPPES record last updated May 1, 2024
Key facts
- NPI
- 1740310044
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 95057 (GA)
- Practice address
- 119 Harmony Xing Ste 3
Eatonton, GA 31024-9571 - Phone
- (706) 485-4004
- NPI assigned
- Mar 6, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Privia Medical Group of Georgia LLC
Practice addresses (Care Compare)
117 Harmony Xing
Suite 1
Eatonton, GA 31024-9548
Phone (762) 320-2100
Hospital & facility affiliations
- St Marys Good Samaritan Hospital
- Navicent Health Baldwin
- Putnam General Hospital
- St Mary'S Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 75 of 100
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240131002939 | GA | Practitioner - Emergency Medicine | 5294825998 | Reassigns benefits to 1 organization |
| I20250606000772 | GA | Practitioner - Family Practice | 5294825998 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Privia Medical Group of Georgia LLC | Family Medicine | Current |
Accepting new patients |
| Cardiology Care Clinic, LLC | Current |
Accepting new patients | |
| Cardiology Care Clinic, LLC | Current |
Accepting new patients | |
| Privia Medical Group of Georgia LLC | Family Medicine | Current |
Accepting new patients |
Locations
3715 Northside Pkwy NW
Bldg 100
Atlanta, GA 30327
Phone (404) 262-7414
117 Harmony Xing
Ste 1
Eatonton, GA 31024
Phone (706) 485-4004
119 Harmony Xing
Ste 3
Eatonton, GA 31024
Phone (706) 485-4004
117 Harmony Xing
Eatonton, GA 31024
101 Yorktown Dr
Ste 100
Fayetteville, GA 30214
Phone (770) 460-4285
Interoperability endpoints
- https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
- diane.peterman.1@8042.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 209484 | NY | |
| Family Medicine Physician | 207Q00000X | 95057 | GA | Yes |
Addresses
Primary practice location
119 Harmony Xing Ste 3
Eatonton, GA 31024-9571
Mailing address
1838 American Way
Lawrenceville, GA 30043-6611
Phone (770) 841-1954
Other providers in Eatonton, GA
- Pathfinders Counseling Services, Inc.
- Rebecca Patrick
- Peaceful Purpose Hospice
- Peaceful Purpose Hospice of Georgia LLC
- Performance Chiropractic & Wellness
- Kimberly Young Phillips
- Phoenix Counseling and Wellness, LLC
- Precious Jem Counseling and Youth Services
- Pretty in Pink Boutique LLC
- Cassandra T Price
All providers in Eatonton, GA · Family Medicine Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 1, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.