Lawrence Dwayne Peavler, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9101232 Issued in FL

Practice address

449 W 23Rd St
Panama City, FL 32405-4507

Phone

(850) 747-7900

NPI assigned

Jun 12, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Blue Wave Emergency Physicians LLC

  • Emergency Medicine Physician
  • Panama City, FL
  • NPI 1093064628
  NPD (past)
• Gulf Emergency Specialists PA

  • Emergency Medicine Physician
  • Panama City, FL
  • NPI 1770521759
  NPD (past)

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249257600000",
    "number": "1902848815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11317",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321201317",
            "telephone_number": "386-274-7800",
            "fax_number": "386-274-7801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "449 W 23RD ST",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054507",
            "telephone_number": "850-747-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEAVLER",
        "first_name": "LAWRENCE",
        "middle_name": "DWAYNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2009-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9101232",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "292429100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Adam Joseph Peaden, DPM
• Stephen P Peaden, P.T.
• Nadine Sue Pearish, ARNP
• Angela J Pearson, N.P.
• Marlee Pease, FNP-BC
• Clayton Peck
• Pediatric Group
• Pediatric Services of America, LLC
• Pediatric Urgent Care PC
• Pediatrics Plus

• Physician Assistant in Panama City, FL
• Providers in Panama City, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.