Olivia Elliott Peters, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

42070 Issued in AL

Practice address

23800 John T Reid Pkwy
Scottsboro, AL 35768-2841

Phone

(256) 999-0808

Fax

(844) 490-5876

NPI assigned

Feb 14, 2007

Last updated

Jun 20, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kids 1St Pediatrics, LLC

  dba Kids First Pediatrics

  • Pediatrics Physician
  • Scottsboro, AL
  • NPI 1376090357
  NPD
• Fort Payne Pediatrics LLC

  • Rural Health Clinic/Center
  • Fort Payne, AL
  • NPI 1033477393

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1841333432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 N KING ST",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968174544",
            "telephone_number": "808-848-1438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23800 JOHN T REID PKWY",
            "city": "SCOTTSBORO",
            "state": "AL",
            "postal_code": "357682841",
            "telephone_number": "256-999-0808",
            "fax_number": "844-490-5876"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "904 Morven Rd",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Wadesboro",
            "state": "NC",
            "postal_code": "281702834",
            "country_code": "US",
            "telephone_number": "704-994-2300",
            "fax_number": "704-994-2353",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "915 N King St",
            "address_purpose": "LOCATION",
            "city": "Honolulu",
            "state": "HI",
            "postal_code": "968174544",
            "country_code": "US",
            "telephone_number": "808-848-1438",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERS",
        "first_name": "OLIVIA",
        "middle_name": "ELLIOTT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-14",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "P20413",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2008-01630",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "HI",
            "license": "22410",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AL",
            "license": "42070",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5910714",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Oconnor, B.S.
• Open MRI of Scottsboro, LLC
• Parks Avenue Drugs
• Charis W Peek, NP
• Gina Marie Herrera Pendleton, PT, DPT
• Coty Phillips Johnson, CRNP
• Stephanie Grider Phillips, CRNP
• David Pierce, D.C.
• Jackson Morgan Pierce, DC
• Jerry D Pierce, M.D.

• Pediatrics Physician in Scottsboro, AL
• Providers in Scottsboro, AL by specialty
• Pediatrics Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.