Look up the most recent NPI and PECOS records

Peter R Bockhorst

Family Medicine

Allopathic & Osteopathic Physicians

PECOS Enrollment

This provider is enrolled in PECOS as PETER BOCKHORST.

Based on the most recent information from CMS, provider Peter R Bockhorst is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 4:18 PM.

Profile Details

Provider ID
1336143866
Provider Type
Individual
Full Name
Bockhorst, Peter R
Title
Dr.
Credential
DO

Gender
Male
Sole Proprietor
No
Enumeration Date
6/13/2005
Last Updated
1/16/2024

Contact Information

Practice Location

102 E Ravine Rd, Kingsport, TN 37660

(423) 245-9600

(423) 245-9634

Mailing Location

PO Box 699, Mountain Home, TN 37684-0699

(423) 433-6039

(423) 433-6060

Provider Taxonomies

Code	Description	License
Code 207Q00000X Primary	Description Family Medicine Allopathic & Osteopathic Physicians	License 1515 Tennessee

Provider Identifiers

ID	Description	Issuer
ID 3307721	Description Medicaid	Issuer Unlisted Tennessee

Peter R Bockhorst

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Holston Medical Group Pc

Pizzola, Jason Laurence

Hubbs, Emily

Hewitt, Sarah N.

Oberdick, Wendy Tipton

Sumpter, Zachary Linuel

Kahle, Kelly

Ananthula, Parvati

Perethian, Kiley Morgan

Jantzi, Curtis Matthew