Peter D Chapman, MD
Individual provider Active NPI Cardiovascular Disease Physician · Eatonton, GA
NPI 1891744298 · NPPES record last updated Jul 27, 2020
Key facts
- NPI
- 1891744298
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Cardiovascular Disease Physician 207RC0000X
- License
- 065348 (GA)
- Practice address
- 119 Harmony Xing Ste 3
Eatonton, GA 31024-9571 - Phone
- (706) 484-4004
- Fax
- (706) 262-2986
- NPI assigned
- May 10, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Cardiovascular Disease (Cardiology)
- Education
- State University of Ny Upstate Medical University, 1979
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Cardiology Care Clinic, LLC
Practice addresses (Care Compare)
119 Harmony Xing
Suite 3
Eatonton, GA 31024-9571
Phone (706) 485-4004
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled 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 |
|---|---|---|---|---|
| I20121004000351 | GA | Practitioner - Cardiovascular Disease (Cardiology) | 3173533494 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22996-20 | WI | MD | Cardiovascular Disease Physician |
| 065348 | GA | MD | Clinical Cardiac Electrophysiology Physician |
| 22996 | WI | MD | Clinical Cardiac Electrophysiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cardiology Care Clinic, LLC | Current |
Accepting new patients | |
| Cardiology Care Clinic, LLC | Cardiovascular Disease | Current |
Accepting new patients |
| Arrhythmia Consultants of Milwaukee, SC | Cardiovascular Disease | Past | Accepting new patients |
Locations
119 Harmony Xing
Eatonton, GA 31024
Phone (706) 485-4004
117 Harmony Xing
Ste 1
Eatonton, GA 31024
Phone (706) 485-4004
1129 Lake Oconee Pkwy
Ste 104
Eatonton, GA 31024
Phone (706) 485-4004
119 Harmony Xing
Ste 3
Eatonton, GA 31024
Phone (706) 485-4004
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 065348 | GA | |
| Cardiovascular Disease Physician | 207RC0000X | 22996-20 | WI | |
| Clinical Cardiac Electrophysiology Physician | 207RC0001X | 22996 | WI | |
| Clinical Cardiac Electrophysiology Physician | 207RC0001X | 065348 | GA | |
| Cardiovascular Disease Physician | 207RC0000X | 065348 | GA | Yes |
Addresses
Primary practice location
119 Harmony Xing Ste 3
Eatonton, GA 31024-9571
Mailing address
119 Harmony Xing Ste 3
Eatonton, GA 31024-9571
Phone (706) 485-4004
Other practice location 1
117 Harmony Crossing
Suite 1
Eatonton, GA 31024-9580
Phone (706) 485-4004
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 003132535C | Medicaid | GA | |
| 30499800 | Medicaid | WI | |
| 003132535A | Medicaid | GA |
Other providers in Eatonton, GA
- Cardiology Care Clinic, LLC
- Cardiology Care Clinic, LLC
- Caring Hearts Home Healthcare, LLC
- Timothy Charles Castellaw
- Melinda Beth Cathey
- Susan Exley Chapman
- Shondalette Chatfield
- Heather Ewing Chronos
- Nicolas A.F. Chronos
- Jessica Elizabeth Anne Coleman
All providers in Eatonton, GA · Cardiovascular Disease 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 Jul 27, 2020. 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.