MR. HARRY MALLETTE IV PEAGLER (AA) – Anesthesiologist Assistant, NPI 1457833105

MR. HARRY MALLETTE IV PEAGLER (AA) is a healthcare provider. based in Rome, Georgia. specializing in ANESTHESIOLOGY ASSISTANT. They hold the professional credentials AA. The NPI Number for MR. HARRY MALLETTE IV PEAGLER (AA) is 1457833105

Main info

Male
Sole Proprietor
8 Years Of Experience
Name
MR. HARRY MALLETTE IV PEAGLER (AA)
NPI
1457833105
Phone
(912) 470-9764
Address
2203 CLARIDGE DR SE
Enumeration Date
29 August 2018
Last Update Date
29 August 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7065095000
Graduation Year
2018 (8 years ago)
PAC ID
2466796149
Group Practice PAC ID
0840338018
Professional Enrollment ID
I20181206002081
Address ID
GA301655621RO304XXSWXX500
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:7State licenses:0Digital endpointsOther names

1,383 ANESTHESIOLOGY ASSISTANT in GA

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Provider Addresses for MR. HARRY MALLETTE IV PEAGLER (AA)

  • 2203 CLARIDGE DR SE

    ROME, GA 301618580

    Phone: (912) 470-9764

    Type: Mailing

  • Floyd Medical Center, 304, Turner McCall Boulevard, DeSoto Homes, Rome, Floyd County, Georgia, 30165, United States

    ROME, GA 301655621

    Phone: (706) 509-5000

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $15.

Total Amount is formed as General ($15) + Research ($0) + Ownership ($0) = $15.

Last reported payment date: 2024-08-21 • Largest payer in this snapshot: Chiesi USA, Inc. ($15).

Total Amount

$15

General + Research + Ownership

Payments

1

Total payment records

General Amount

$15

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-08-21

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Chiesi USA, Inc.$15
View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2018-12-06

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20181206002081IAnesthesiology AssistantGATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 30161)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0840338018View full group profile
NameSpecialtyState
A N E S T H E S I O L O G YGA
Certified Registered Nurse Anesthetist (Crna)KY
Certified Registered Nurse Anesthetist (Crna)GA
Anesthesiology AssistantMO
-GA
Certified Registered Nurse Anesthetist (Crna)FL
-GA
-FL
-GA
Certified Registered Nurse Anesthetist (Crna)GA

Reviews

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Frequently asked questions

Is MR. HARRY MALLETTE IV PEAGLER (AA) listed with a National Provider Identifier?
Yes — MR. HARRY MALLETTE IV PEAGLER (AA) has NPI 1457833105 on file in the registry.
Is MR. HARRY MALLETTE IV PEAGLER (AA) shown as active in public data?
Registry records indicate MR. HARRY MALLETTE IV PEAGLER (AA) maintains an active NPI.
How would a patient describe MR. HARRY MALLETTE IV PEAGLER (AA)'s focus?
For MR. HARRY MALLETTE IV PEAGLER (AA), the primary taxonomy reads as Anesthesiologist Assistant. Clinical services aligned with this taxonomy classification.
Where in Georgia is MR. HARRY MALLETTE IV PEAGLER (AA) registered?
Use Rome, Georgia as the headline location for MR. HARRY MALLETTE IV PEAGLER (AA) here.
Can I trust this NPI listing for MR. HARRY MALLETTE IV PEAGLER (AA)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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