NPIMap

Individual provider Active NPI

Cornell Peters, MD

  • Family Medicine Physician
  • Macon, GA
National Provider Identifier
1861487225
Registry record updated Sep 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
042695 Issued in GA
Practice address
2040 Bowman Park
Suite a
Macon, GA 31210-5782
Phone
(478) 755-8400
Fax
(478) 755-1073
NPI assigned
Sep 13, 2005
Last updated
Sep 10, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 042695 GA Primary

Addresses

Primary practice location

2040 Bowman Park
Suite a
Macon, GA 31210-5782

Mailing address

2040 Bowman Park
Suite a
Macon, GA 31210-5782
Phone (478) 755-8400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100702000437 GA Practitioner - Family Practice 1557492758 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Iowa, RJ & L Carver College of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southern Primary Care, LLCGroup PAC ID 3173897196, 5 clinicians
Trinity Wellness Center LLCGroup PAC ID 8527314780, 4 clinicians

Practice addresses (Care Compare)

2040 Bowman Park
Suite a
Macon, GA 31210-5913
Phone (478) 755-8400

9434 S Main St
Suite 1100
Jonesboro, GA 30236-6092
Phone (770) 478-1300

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
042695GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
KCP Enterprises CurrentSince Jul 15, 2024 Accepting new patients
Joint Regeneration & Anti-Aging of CurrentSince Dec 1, 2021 Accepting new patients
Southern Primary Care, LLC CurrentSince Apr 13, 2025 Accepting new patients
Trinity Wellness Center, LLC. Family Medicine CurrentSince Jan 30, 2025 Accepting new patients
Macon Family Health Center Inc Family Medicine CurrentSince Oct 1, 1999 Accepting new patients
Coliseum Health Group LLC Family Medicine Past Accepting new patients
Beyond Mental Health Wellness LLC Past Accepting new patients

Locations

9434 S Main St
Ste 1100
Jonesboro, GA 30236
Phone (770) 478-1300

197 Bass Rd
Macon, GA 31210
Phone (478) 365-2164

2040 Bowman Park
Ste A
Macon, GA 31210
Phone (404) 944-7914

6501 Peake Rd
Ste 400
Macon, GA 31210
Phone (478) 477-0966

1601 Georgian Park
Ste Ter
Peachtree Cty, GA 30269
Phone (678) 834-5526

203 Woodpark Pl
Ste 102
Woodstock, GA 30188
Phone (678) 748-3343

Interoperability endpoints

  • Direct secure messaging: cornell.peters@fml-ga.direct.office.nextgen.com
  • Direct secure messaging: drcornellpetersmd@mfhci-ga.direct.office.nextgen.com
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 7

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.

Hospital & facility affiliations 2

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": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757462400000",
    "number": "1861487225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2040 BOWMAN PARK",
            "address_2": "SUITE A",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312105782",
            "telephone_number": "478-755-8400",
            "fax_number": "478-755-1073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 BOWMAN PARK",
            "address_2": "SUITE A",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312105782",
            "telephone_number": "478-755-8400",
            "fax_number": "478-755-1073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "CORNELL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-13",
        "last_updated": "2025-09-10",
        "certification_date": "2025-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "042695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.