MRS. KIMBERLY DENISE PEGUES FNP-C
NPI 1073663167
Nurse Practitioner - Family in Loganville, GA

NPI Status: Active since January 11, 2007

Contact Information

3869 HIGHWAY 81
LOGANVILLE, GA
ZIP 30052
Phone: (678) 635-8650

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  • Individual
  • Female
  • Nurse Practitioner
  • Family
  • Accepts Insurance
  • PECOS Enrolled
  • Medicare Quality Reporting

About KIMBERLY PEGUES

This page provides the complete NPI Profile along with additional information for Kimberly Pegues, a provider established in Loganville, Georgia with a medical specialization in Nurse Practitioner, focusing in family . The healthcare provider is registered in the NPI registry with number 1073663167 assigned on January 2007. The practitioner's primary taxonomy code is 363LF0000X with license number RN127796 (GA). The provider is registered as an individual and her NPI record was last updated 6 years ago.

NPI
1073663167
Provider Name
MRS. KIMBERLY DENISE PEGUES FNP-C
Gender
Female
Entity Type
Individual
Location Address
3869 HIGHWAY 81 LOGANVILLE, GA 30052
Location Phone
(678) 635-8650
Mailing Address
1500 WHEAT GRASS WAY GRAYSON, GA 30017
Mailing Phone
(678) 362-0570
Is Sole Proprietor?
No
Enumeration Date
01-11-2007
Last Update Date
06-15-2020
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A nurse practitioner (NP) like Kimberly Pegues is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.

Location Map

Secondary Locations

  • 2675 N Decatur Rd 506
    Decatur, GA 30033
    (404) 299-1679

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Nurse Practitioner Family

Taxonomy Code
363LF0000X
Type
Physician Assistants & Advanced Practice Nursing Providers
License No.
RN127796
License State
GA

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Bronze Classic 4700 - EPO
  • Bronze Classic 4700 | MercyOne - EPO
  • Bronze Classic Standard - EPO
  • Bronze Classic Standard | MercyOne - EPO
  • Bronze Elite + PCP Saver Plus - EPO
  • Bronze Elite + PCP Saver Plus | MercyOne - EPO
  • Bronze Simple Breathe Easy with Enhanced COPD Benefits | MercyOne - EPO
  • Bronze Simple Chronic Care CKM | MercyOne - EPO
  • Bronze Simple Diabetes | MercyOne - EPO
  • Gold Classic Standard - EPO
  • Gold Classic Standard | MercyOne - EPO
  • Gold Elite - EPO
  • Gold Elite | MercyOne - EPO
  • Secure - EPO
  • Secure | MercyOne - EPO
  • Silver Classic - EPO
  • Silver Classic | MercyOne - EPO
  • Silver Classic Standard - EPO
  • Silver Classic Standard | MercyOne - EPO
  • Silver Simple Breathe Easy with Enhanced COPD Benefits | MercyOne - EPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Kimberly Pegues is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Durable Medical Equipment (DME) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: No

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): No

  • Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Established patient office or other outpatient visit, 10-19 minutes

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

This service was performed 12 times for 12 patients

Established patient office or other outpatient visit, 20-29 minutes

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

This service was performed 16 times for 15 patients

Established patient office or other outpatient visit, 30-39 minutes

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

This service was performed 21 times for 21 patients

Follow-up hospital inpatient care per day, typically 25 minutes

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

This service was performed 68 times for 44 patients

Initial hospital inpatient care per day, typically 50 minutes

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

This service was performed 11 times for 11 patients

New patient office or other outpatient visit, 15-29 minutes

This service involves an initial visit to the doctor's office or other outpatient setting. It typically lasts between 15-29 minutes. The doctor will review your medical history, conduct a physical examination, and discuss your health concerns. It's a chance to establish your health baseline and address any immediate medical issues.

This service was performed 37 times for 37 patients

New patient office or other outpatient visit, 45-59 minutes

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

This service was performed 25 times for 25 patients

Physician Visit Costs

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 30052 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $88.06
  • Minimum New Patient Price $56.84
  • Maximum New Patient Price $172.43
  • Average New Patient Copayment $22.01
  • Minimum New Patient Copayment $14.21
  • Maximum New Patient Copayment $43.1

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $100.2
  • Minimum Established Patient Price $18.22
  • Maximum Established Patient Price $140.4
  • Average Established Patient Copayment $25.05
  • Minimum Established Patient Copayment $4.55
  • Maximum Established Patient Copayment $35.1

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Quality Reporting

The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

Quality Measure Performance Number of Patients
Advance Care PlanningYesN/A
Implementation of practices/processes to develop advance care planning that includes: documenting the advance care plan or living will within the medical record, educating clinicians about advance care planning motivating them to address advance care planning needs of their patients, and how these needs can translate into quality improvement, educating clinicians on approaches and barriers to talking to patients about end-of-life and palliative care needs and ways to manage its documentation, as well as informing clinicians of the healthcare policy side of advance care planning.
Implementation of medication management practice improvementsYesN/A
Manage medications to maximize efficiency, effectiveness and safety that could include one or more of the following: Reconcile and coordinate medications and provide medication management across transitions of care settings and eligible clinicians or groups; Integrate a pharmacist into the care team; and/or Conduct periodic, structured medication reviews.
Measurement and Improvement at the Practice and Panel LevelYesN/A
Measure and improve quality at the practice and panel level, such as the American Board of Orthopaedic Surgery (ABOS) Physician Scorecards, that could include one or more of the following: • Regularly review measures of quality, utilization, patient satisfaction and other measures that may be useful at the practice level and at the level of the care team or MIPS eligible clinician or group (panel); and/or • Use relevant data sources to create benchmarks and goals for performance at the practice level and panel level.
Participation in an AHRQ-listed patient safety organization.YesN/A
Participation in an AHRQ-listed patient safety organization.

Reviews for MRS. KIMBERLY DENISE PEGUES FNP-C

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1073663167, we treat the final digit (7) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 53. The final step is to find the difference between that total and the next multiple of ten (60 - 53 = 7).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
0
Unchanged
Pos 3
7
Doubled → 14 → 1 + 4
Pos 4
3
Unchanged
Pos 5
6
Doubled → 12 → 1 + 2
Pos 6
6
Unchanged
Pos 7
3
Doubled → 6
Pos 8
1
Unchanged
Pos 9
6
Doubled → 12 → 1 + 2
Check
7
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 7 → 14 → 5 6 → 12 → 3 3 → 6 6 → 12 → 3

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 0 + 1 + 4 + 3 + 1 + 2 + 6 + 6 + 1 + 1 + 2 + 24 = 53

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 53 is 60. The difference is the calculated check digit.

60 - 53 = 7
This NPI is valid
The calculated check digit is 7, which matches the last digit of 1073663167.

Other Providers at the Same Location


The following 7 providers are registered at the same or a nearby location.

Physical Therapist
3869 HIGHWAY 81
LOGANVILLE, GA 30052
Obstetrics & Gynecology
3869 HIGHWAY 81
LOGANVILLE, GA 30052
Obstetrics & Gynecology
3869 HIGHWAY 81
LOGANVILLE, GA 30052
Internal Medicine (Gastroenterology)
3869 HIGHWAY 81
LOGANVILLE, GA 30052
Obstetrics & Gynecology
3869 HIGHWAY 81
LOGANVILLE, GA 30052
Nurse Practitioner
3869 HIGHWAY 81
LOGANVILLE, GA 30052
Physician Assistant
3869 HIGHWAY 81
LOGANVILLE, GA 30052

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1073663167, enumerated as an "individual" on January 11, 2007.

The provider is located at 3869 HIGHWAY 81 LOGANVILLE, GA 30052 and the phone number is (678) 635-8650.

Nurse Practitioner with taxonomy code 363LF0000X and a focus in Family.

The provider might be accepting Accepts: Oscar Insurance Company. Please consult your insurance carrier or call the provider to verify.