Individual provider Active NPI

Brandon Peffer

  • Physician Assistant
  • Nashville, TN
National Provider Identifier
1780013862
Registry record updated Nov 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2438 Issued in TN
Practice address
2410 Patterson St
Suite 212
Nashville, TN 37203-1551
Phone
(615) 342-7345
NPI assigned
Nov 8, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2438 TN Primary

Addresses

Primary practice location

2410 Patterson St
Suite 212
Nashville, TN 37203-1551

Mailing address

630 Timber LN
Nashville, TN 37215-1120
Phone (615) 495-9921

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141211000724 TN Practitioner - Physician Assistant 0840512372 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2438TNMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Centennial Surgical Clinic, LLC Physician Assistant Past Accepting new patients
Cane Ridge Emergency Physicians LLC Past Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1383868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383868800000",
    "number": "1780013862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 TIMBER LN",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372151120",
            "telephone_number": "615-495-9921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2410 PATTERSON ST",
            "address_2": "SUITE 212",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372031551",
            "telephone_number": "615-342-7345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEFFER",
        "first_name": "BRANDON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-11-08",
        "last_updated": "2013-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "2438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

Verify at the official NPI Registry.