Thelia Jean Pettigrew, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

LPN0000067544 Issued in TN

Practice address

219 Princeton Rd
Johnson City, TN 37601-2052

Phone

(423) 975-2200

NPI assigned

Feb 21, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1361404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361404800000",
    "number": "1033459508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4368 CLEAR SPRINGS RD",
            "city": "LIMESTONE",
            "state": "TN",
            "postal_code": "376815044",
            "telephone_number": "423-257-8869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 PRINCETON RD",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376012052",
            "telephone_number": "423-975-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTIGREW",
        "first_name": "THELIA",
        "middle_name": "JEAN",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-21",
        "last_updated": "2013-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "TN",
            "license": "LPN0000067544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steve Leroy Peterson, M.D.
• Tracey E Peterson, BSW
• Erica Petree, LCSW
• Caitlen M Petschke, PA-C
• Elizabeth A Pettey, NP
• Hannah Jo Pettit, PA-C
• Joshua Robert Pettit, PA
• Justin Pettit, PA
• Kylee Leann Pettit, PA
• Pharmacy Specialty Services

• Licensed Practical Nurse in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Licensed Practical Nurse in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.