DR. ROOSEVELT JR. PEEBLES (M.D) – Plastic Surgery Physician, NPI 1073591731

DR. ROOSEVELT JR. PEEBLES (M.D) is a healthcare provider. based in Nashville, Tennessee. specializing in Plastic Surgery Physician. They hold the professional credentials M.D. They hold a License No. MD024686 (TN). The NPI Number for DR. ROOSEVELT JR. PEEBLES (M.D) is 1073591731

Main info

Male
41 Years Of Experience
Accepts Medicare Assignment
Name
DR. ROOSEVELT JR. PEEBLES (M.D)
NPI
1073591731
Phone
(615) 320-9300
Address
2014 CLIFTON AVE
Enumeration Date
4 January 2006
Last Update Date
3 May 2019

Doctor Profile

Medical School Name
RUTGERS R W JOHNSON MEDICAL SCHOOL (CAM/NEW BRUNS/PISC)
Secondary Phone
-
Graduation Year
1985 (41 years ago)
PAC ID
6608036959
Professional Enrollment ID
I20120326000038
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

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Provider Addresses for DR. ROOSEVELT JR. PEEBLES (M.D)

  • Clifton Avenue, Nashville, Davidson County, Tennessee, 37209, United States

    NASHVILLE, TN 372031910

    Phone: (615) 320-9300

    Fax: (615) 320-3065

    Type: Mailing

  • Patterson Street, Radnor, Nashville, Davidson County, Tennessee, 37211, United States

    SUITE 205

    NASHVILLE, TN 372032192

    Phone: (615) 320-9300

    Fax: (615) 320-3065

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2012-03-26

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
I20120326000038IPlastic And Reconstructive SurgeryTNTBD

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 37203)

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Reviews

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Frequently asked questions

What federal number belongs to DR. ROOSEVELT JR. PEEBLES (M.D)?
The federal identifier for DR. ROOSEVELT JR. PEEBLES (M.D) is NPI 1073591731.
Is DR. ROOSEVELT JR. PEEBLES (M.D) active in the national directory?
DR. ROOSEVELT JR. PEEBLES (M.D)'s public NPI profile is in an active state.
What kind of provider is DR. ROOSEVELT JR. PEEBLES (M.D)?
The page reflects Plastic Surgery Physician for DR. ROOSEVELT JR. PEEBLES (M.D). Clinical services aligned with this taxonomy classification.
What location metadata exists for DR. ROOSEVELT JR. PEEBLES (M.D)?
The page summarizes Nashville, Tennessee for DR. ROOSEVELT JR. PEEBLES (M.D); expand the address list for detail.
How can I contact DR. ROOSEVELT JR. PEEBLES (M.D)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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