Individual provider Active NPI

Terry D Peery, MD

  • Emergency Medicine Physician
  • Jacksonville, AR
National Provider Identifier
1811198039
Registry record updated Jul 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
E-5482 Issued in AR
Practice address
1101 N James St
Jacksonville, AR 72076-3119
Phone
(501) 241-1919
NPI assigned
May 29, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X E-5482 AR
Emergency Medicine Physician 207P00000X E-5482 AR Primary

Addresses

Primary practice location

1101 N James St
Jacksonville, AR 72076-3119

Mailing address

1101 N James St
Jacksonville, AR 72076-3119
Phone (501) 241-1919

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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

Enrollment IDStateProvider typePAC IDDetails
I20080623000530 AR Practitioner - Emergency Medicine 0446321152 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Arkansas College of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Faulkner Emergency Group, PLLCGroup PAC ID 1557694049, 19 clinicians

Practice addresses (Care Compare)

2302 College Ave
Conway, AR 72034-6297
Phone (501) 329-3831

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
E-5482ARMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Conway Regional Medical Center Inc General Practice CurrentSince Jan 8, 2018 Accepting new patients
Southeastern Emergency Physicians LLC Emergency Medicine CurrentSince May 6, 2020 Accepting new patients
Faulkner Emergency Group, PLLC Emergency Medicine CurrentSince May 22, 2019 Accepting new patients
Conway Regional Medical Center Inc CurrentSince Jan 8, 2018 Accepting new patients
Arkansas Emergency Staffing Solutions, Inc Emergency Medicine CurrentSince Oct 16, 2013 Accepting new patients

Locations

2302 College Ave
Conway, AR 72034
Phone (501) 329-3831

1015 Unity Rd
Crossett, AR 71635
Phone (870) 364-0590

4800 E Johnson Ave
Jonesboro, AR 72405
Phone (870) 732-2100

1808 W Main St
Russellville, AR 72801
Phone (479) 964-4178

Organizations & group practices 5

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499817600000",
    "number": "1811198039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 N JAMES ST",
            "city": "JACKSONVILLE",
            "state": "AR",
            "postal_code": "720763119",
            "telephone_number": "501-241-1919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 N JAMES ST",
            "city": "JACKSONVILLE",
            "state": "AR",
            "postal_code": "720763119",
            "telephone_number": "501-241-1919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEERY",
        "first_name": "TERRY",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-29",
        "last_updated": "2017-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "AR",
            "license": "E-5482",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AR",
            "license": "E-5482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, AR

Sources for this page

Verify at the official NPI Registry.