Justin Wayne Peterson (NPI# 1073893616, PAC ID# 8123324555) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OBSTETRICS/GYNECOLOGY.
Nation Provider ID (NPI) | 1073893616 |
PAC ID by PECOS | 8123324555 |
Professional Enrollment ID | I20190109002234 |
Full Name | Justin Wayne Peterson |
Organization Legal Name | CRH PHYSICIAN PRACTICES, LLC |
Address |
2010 Ocilla Rd Douglas GA 31533-2230 |
Phone Number | 9123842500 |
Gender | M |
Medical School | MERCER UNIVERSITY SCHOOL OF MEDICINE |
Graduation Year | 2014 |
Primary Specialty | OBSTETRICS/GYNECOLOGY |
Group Practice PAC ID | 5193727964 |
Number of Group Practice Members | 29 |
Accepts Medicare Assignment | Y |
Claim Control Number (CCN) | Legal Business Name |
---|---|
110089 | COFFEE REGIONAL MEDICAL CENTER |
Address | Phone | Organization |
---|---|---|
2010 Ocilla Rd, Douglas, GA 31533-2230 | 9123842500 | CRH PHYSICIAN PRACTICES, LLC |
Organization Legal Name | CRH PHYSICIAN PRACTICES, LLC |
Physicians | 32 |
Name | Specialty | Organization | Address |
---|---|---|---|
Nancy Danielle Collins | Nurse Practitioner | Crh Physician Practices, LLC | 903 Ward W St B, Douglas, GA 31533-3536 |
Michelle Martinez Jones | Nurse Practitioner | Crh Physician Practices, LLC | 200 Doctors Dr S, Douglas, GA 31533-2203 |
Thaihang Nguyen | Family Medicine | Crh Physician Practices, LLC | 1100 Ward St W Ext, Douglas, GA 31533-1902 |
Michal Aimee Edmund | Nurse Practitioner | Crh Physician Practices, LLC | 200 Doctors Dr L, Douglas, GA 31533-2202 |
Charles Bagwell | General Surgery | Crh Physician Practices, LLC | 100 Doctors Dr C, Douglas, GA 31533-2211 |
Chester Theo Royals Jr. | General Surgery | Crh Physician Practices, LLC | 1100 Ward St W Ext, Douglas, GA 31533-1902 |
Willie W Bell | Cardiovascular Disease (cardiology) | Crh Physician Practices, LLC | 1101 Ocilla Rd, Suite A, Douglas, GA 31533-2207 |
Joel W Ferree | Cardiovascular Disease (cardiology) | Crh Physician Practices, LLC | 1100 Ward St W Ext, Douglas, GA 31533-1902 |
Alfred W Mazur | Urology | Crh Physician Practices, LLC | 1100 Ward St W Ext, Douglas, GA 31533-1902 |
Jesse Allen Kane | Obstetrics/gynecology | Crh Physician Practices, LLC | 1100 Ward St W Ext, Douglas, GA 31533-1902 |
Street Address |
2010 OCILLA RD |
City | DOUGLAS |
State | GA |
Zip | 31533-2230 |
Name | Specialty | Organization | Address |
---|---|---|---|
Challori J Reddy | Urology | Crh Physician Practices, LLC | 2010 Ocilla Rd, Douglas, GA 31533-2230 |
Cathy Herrington | Nurse Practitioner | Crh Physician Practices, LLC | 2010 Ocilla Rd, Douglas, GA 31533-2230 |
Hali Varnedore | Nurse Practitioner | Crh Physician Practices, LLC | 2010 Ocilla Rd, Douglas, GA 31533-2230 |
Name | Specialty | Organization | Address |
---|---|---|---|
Henry Randall Sheffield | Chiropractic | 410 Ward E St, Douglas, GA 31533-0001 | |
Heather Cason Carver | Registered Dietitian Or Nutrition Professional | 204 Gaskin Ave N, Douglas, GA 31533-0400 | |
Thaihang Nguyen | Family Medicine | Crh Physician Practices, LLC | 1100 Ward St W Ext, Douglas, GA 31533-1902 |
Stephen R Miller | Physical Therapy | 1150 W Ward St Extension, Suite B1, Douglas, GA 31533-1902 | |
Chester Theo Royals Jr. | General Surgery | Crh Physician Practices, LLC | 1100 Ward St W Ext, Douglas, GA 31533-1902 |
Joel W Ferree | Cardiovascular Disease (cardiology) | Crh Physician Practices, LLC | 1100 Ward St W Ext, Douglas, GA 31533-1902 |
Alfred W Mazur | Urology | Crh Physician Practices, LLC | 1100 Ward St W Ext, Douglas, GA 31533-1902 |
Jesse Allen Kane | Obstetrics/gynecology | Crh Physician Practices, LLC | 1100 Ward St W Ext, Douglas, GA 31533-1902 |
Kimberly E Lott | Physician Assistant | Crh Physician Practices, LLC | 1100 Ward St W Ext, Douglas, GA 31533-1902 |
Amanda Bice | Nurse Practitioner | Crh Physician Practices, LLC | 1100 Ward St W Ext, Douglas, GA 31533-1902 |
Find all physicians in zip 31533 |
City | DOUGLAS |
Zip Code | 31533 |
Specialty | OBSTETRICS/GYNECOLOGY |
City + Specialty | DOUGLAS + OBSTETRICS/GYNECOLOGY |
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Data Provider | Centers for Medicare & Medicaid Services (CMS) |
Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.