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DR. PHILLIP ALLEN PETERSON MD
NPI 1104882596
Family Medicine in Princeton, WV

Active since April 25, 2006PECOS EnrolledAccepts Medicare Assignment
3997 BECKLEY RD, PRINCETON, WV 24740(304) 431-5499(304) 431-3400 Get Directions Write a Review

NPPES record last updated: January 6, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. Phillip Allen Peterson Md NPPES

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

DR. PHILLIP ALLEN PETERSON MD (NPI 1104882596) is an individual family medicine provider in Princeton, West Virginia, licensed in Virginia (0101042606) and active in the NPI registry since April 2006. He is enrolled in Medicare PECOS, is affiliated with Carilion Tazewell Community Hospital, and is a graduate of University Of Iowa, Rj & L Carver College Of Medicine (1985).

NPPES Registry Identity

NPI1104882596
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. PHILLIP ALLEN PETERSONCredential: MD
Location Address3997 BECKLEY RDPrinceton, WV 24740-7660
Mailing Address3997 Beckley RdPrinceton, WV 24740-7660 · (304) 431-5499 · Fax (304) 431-3400
Phone(304) 431-5499
Fax(304) 431-3400
Sole ProprietorNo
Medical School CMSUniversity Of Iowa, Rj & L Carver College Of MedicineGraduated 1985
Enumeration DateApril 25, 2006
Last NPPES UpdateJanuary 6, 2021
NPPES CertifiedJanuary 6, 2021
✔ NPI 1104882596 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in VA · 0101042606
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
3997 BECKLEY RD, Princeton, WV 24740
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource, Highmark Blue Cross Blue Shield West Virginia.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Phillip Allen Peterson Md 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 ID8628075942
PECOS Enrollment IDI20061031000016, I20110118000188
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Phillip Peterson reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Bluestone Health Association, Inc.
Same address
Federally Qualified Health Center (FQHC)
3997 BECKLEY RD
Princeton, WV 24740
NPI 1346266848 (304) 431-5499
Princeton Community Hospital Assn., Inc
11 mi
Family Medicine
510 CHERRY ST, SUITE 102
Bluefield, WV 24701
  • Reassigned Medicare billing, Virginia enrollment
  • Medicare enrollment name: Bluefield Clinic Company LLC
  • 8 clinicians in this Medicare group
NPI 1518273507 (304) 327-1775

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Hospital Affiliations CMS Care Compare 2

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

Carilion Tazewell Community Hospital

Acute Care Hospitals · Tazewell, VA
OwnershipVoluntary non-profit - Other
CMS Certification Number490117
Location388 Ben Bolt AvenueTazewell, VA 24651 · Tazewell County
Emergency services

Princeton Community Hospital

Acute Care Hospitals · Princeton, WV
1/5 CMS rating
OwnershipGovernment - Local
CMS Certification Number510046
Location122 12th StreetPrinceton, WV 24740 · Mercer County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 24740 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
$83.49 typical visit price
range $53.20 – $164.59
Typical copayment $20.87 (range $13.30 – $41.14)
Most-billed visit code 99203
Established Patient
$94.81 typical visit price
range $16.47 – $133.29
Typical copayment $23.70 (range $4.11 – $33.32)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 6

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
7 suppliers19 claims51 services$5.67 avg. paid by Medicare
Ostomy skin barrier, pectin-based, paste, per ounce A4406
DME-Orthotic Devices · category DF010N
3 suppliers11 claims44 services$4.96 avg. paid by Medicare
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
4 suppliers13 claims13 services$18.16 avg. paid by Medicare
Continuous positive airway pressure (cpap) device E0601
DME-Other DME · category DE001N
2 suppliers16 claims16 services$46.85 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
6 suppliers28 claims28 services$103.97 avg. paid by Medicare
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
2 suppliers30 claims30 services$181.41 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

LEIGH BROOKS APRN FNP-C
Nurse Practitioner
3997 BECKLEY RD
PRINCETON, WV 24740
Mercer County (304) 431-5499
MR. WILLIAM CLAUDE BIRD MD
Family Medicine
3997 BECKLEY RD, BLUESTONE HEALTH ASSOC
PRINCETON, WV 24740
Mercer County (304) 431-5499
JACINDA NICOLE FARNSWORTH
Nurse Practitioner (Family)
3997 BECKLEY RD
PRINCETON, WV 24740
Mercer County (304) 431-5499
MRS. JENNIFER R RIFFE PAC
Physician Assistant
3997 BECKLEY RD
PRINCETON, WV 24740
Mercer County (304) 431-5499
MRS. SUSAN FAWN BLEVINS FNP
Nurse Practitioner (Family)
3997 BECKLEY RD
PRINCETON, WV 24740
Mercer County (304) 431-5499
MRS. BRANDI HUFFMAN PA-C
Physician Assistant
3997 BECKLEY RD
PRINCETON, WV 24740
Mercer County (304) 431-5499
JESSICA ANN DEEL NP-C
Nurse Practitioner (Family)
3997 BECKLEY RD
PRINCETON, WV 24740
Mercer County (304) 431-5499
BLUESTONE HEALTH ASSOCIATION, INC.
Clinic/Center (Federally Qualified Health Center (FQHC))
3997 BECKLEY RD
PRINCETON, WV 24740
Mercer County (304) 431-5499

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 Phillip Peterson's NPI number?

The NPI number for Phillip Peterson is 1104882596. It was assigned to this individual provider in the NPPES registry on April 25, 2006.

Where is Phillip Peterson located?

Phillip Peterson practices at 3997 Beckley Rd, Princeton, WV 24740. The listed phone number is (304) 431-5499.

What is Phillip Peterson's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Phillip Peterson enrolled in Medicare?

Yes. Phillip Peterson 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.

Which organizations bill Medicare for Phillip Peterson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Phillip Peterson reassigns Medicare benefits to 2 organizations: Bluestone Health Association, Inc. (Princeton, WV) and Princeton Community Hospital Assn., Inc (Bluefield, WV). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Phillip Peterson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Phillip Peterson accept?

Health plans from CareSource and Highmark Blue Cross Blue Shield West Virginia list Phillip Peterson 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 Phillip Peterson affiliated with any hospitals?

According to CMS data, Phillip Peterson is affiliated with Carilion Tazewell Community Hospital and Princeton Community Hospital.

When was this NPI record last updated?

The NPPES record for Phillip Peterson was last updated on January 6, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.