Janet Sue Pettyjohn, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

3595 Issued in FL

Practice address

6302 Benjamin Rd
Suite # 410
Tampa, FL 33634-5116

Phone

(813) 639-9119

Fax

(813) 639-1039

NPI assigned

Oct 13, 2006

Last updated

Sep 29, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Osteopathy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475107200000",
    "number": "1033209937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6302 BENJAMIN RD",
            "address_2": "SUITE # 410",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336345116",
            "telephone_number": "813-639-9119",
            "fax_number": "813-639-1039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6302 BENJAMIN RD",
            "address_2": "SUITE # 410",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336345116",
            "telephone_number": "813-639-9119",
            "fax_number": "813-639-1039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTYJOHN",
        "first_name": "JANET",
        "middle_name": "SUE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-13",
        "last_updated": "2016-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "3595",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "057576300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erika Sue Pettinato, D.M.D., M.S.
• Jason Pettit, RBT
• Matthew J Pettit, APRN
• Meta Lashon Petty, LCSW
• Michelle L Petty, M.S., LMHC
• Justin Lee Pevner, MD
• Elaine A Peyno
• Carmen Peyton, R.N.F.A.
• Michelle Elizabeth Pezo, PA-C
• Mikel Pezonaga Muguira, FNP-C

• Family Medicine Physician in Tampa, FL
• Providers in Tampa, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.