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MR. CHARLES LEROY PEACOCK CRNA
NPI 1063548964
Nurse Anesthetist, Certified Registered in Lawrenceville, GA

Active since February 26, 2007Accepts Medicare Assignment
1000 MEDICAL CENTER BLVD, LAWRENCEVILLE, GA 30045(678) 442-4321 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mr. Charles Leroy Peacock Crna NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. CHARLES LEROY PEACOCK CRNA (NPI 1063548964) is an individual nurse anesthetist, certified registered in Lawrenceville, Georgia, licensed in Georgia (RN182133 CRNA) and active in the NPI registry since February 2007. He is affiliated with Avala and is a graduate of Other (2014).

NPPES Registry Identity

NPI1063548964
Entity TypeIndividualMale
Primary Taxonomy367500000X
Provider Legal NameMR. CHARLES LEROY PEACOCKCredential: CRNA
Location Address1000 MEDICAL CENTER BLVDLawrenceville, GA 30045-7694
Mailing Address840 Connell LnLawrenceville, GA 30044-6123 · (770) 736-5173
Phone(678) 442-4321
Sole ProprietorNo
Medical School CMSOtherGraduated 2014
Enumeration DateFebruary 26, 2007
Last NPPES UpdateJuly 8, 2007
✔ NPI 1063548964 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code367500000X
License✔ Licensed in GA · RN182133 CRNA
Definition
(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.
1000 MEDICAL CENTER BLVD, Lawrenceville, GA 30045
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HMO Louisiana.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Charles Leroy Peacock Crna is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1355447202
PECOS Enrollment IDI20140731001161

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Anesthesia for procedure to correct abnormal heart rhythm 00410
Anesthesia for a procedure to correct abnormal heart rhythm ensures you won't feel pain during the treatment. It can be general, where you're completely asleep, or local, numbing only a specific area. Your vital signs are monitored to ensure safety during the procedure.
12 services11 patients
Anesthesia for procedure to assess heart electrical activity 00537
Anesthesia for a procedure to assess heart electrical activity helps ensure comfort and relaxation. It involves administering medication that either numbs a specific area or makes you sleep temporarily. This allows doctors to safely examine your heart's electrical signals without causing discomfort.
12 services12 patients
Anesthesia for x-ray or radiation therapy 01922
Anesthesia for x-ray or radiation therapy involves administering medication to help you relax or sleep during the procedure. It's used to ensure comfort, minimize movement, and reduce anxiety. The type of anesthesia used depends on the procedure and patient's health.
12 services12 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Avala

Acute Care Hospitals · Covington, LA
OwnershipPhysician
CMS Certification Number190267
Location67252 Industry LaneCovington, LA 70433 · St. Tammany County

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30045 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$130.64 typical visit price
range $56.84 – $172.43
Typical copayment $32.66 (range $14.21 – $43.10)
Most-billed visit code 99204
Established Patient
$70.85 typical visit price
range $18.22 – $140.40
Typical copayment $17.71 (range $4.55 – $35.10)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

AMANARH ALBERT KISSEIH MD
Emergency Medicine
1000 MEDICAL CENTER BLVD
LAWRENCEVILLE, GA 30045
Gwinnett County (678) 442-3317
DR. CRAIG M SPECTOR MD
Anesthesiology
1000 MEDICAL CENTER BLVD
LAWRENCEVILLE, GA 30045
Gwinnett County (770) 963-9905
DONALD ALFRED RUF MD
Emergency Medicine
1000 MEDICAL CENTER BLVD
LAWRENCEVILLE, GA 30045
Gwinnett County (678) 442-3317
DR. STEPHEN F LEGUM MD
Radiology (Diagnostic Radiology)
1000 MEDICAL CENTER BLVD
LAWRENCEVILLE, GA 30045
Gwinnett County (770) 995-4321
MRS. KIMBERLY MARIE SMITH FNP-C
Nurse Practitioner (Family)
1000 MEDICAL CENTER BLVD
LAWRENCEVILLE, GA 30045
Gwinnett County (678) 442-4350
JUNE ELLEN SELBY CNM
Advanced Practice Midwife
1000 MEDICAL CENTER BLVD, OB CLINIC
LAWRENCEVILLE, GA 30045
Gwinnett County (678) 312-4616
DR. DOUGLAS H SEEB MD
Radiology (Diagnostic Radiology)
1000 MEDICAL CENTER BLVD, RADIOLOGY DEPT
LAWRENCEVILLE, GA 30045
Gwinnett County (770) 995-4321
DR. JAMES LOFTON SMITH JR. M.D.
Emergency Medicine
1000 MEDICAL CENTER BLVD
LAWRENCEVILLE, GA 30045
Gwinnett County (678) 442-3317

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Charles Peacock's NPI number?

The NPI number for Charles Peacock is 1063548964. It was assigned to this individual provider in the NPPES registry on February 26, 2007.

Where is Charles Peacock located?

Charles Peacock practices at 1000 Medical Center Blvd, Lawrenceville, GA 30045. The listed phone number is (678) 442-4321.

What is Charles Peacock's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

Is Charles Peacock enrolled in Medicare?

Yes. Charles Peacock is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Charles Peacock accept?

Health plans from HMO Louisiana list Charles Peacock as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Charles Peacock affiliated with any hospitals?

According to CMS data, Charles Peacock is affiliated with Avala.

When was this NPI record last updated?

The NPPES record for Charles Peacock was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.