Organization Active NPI

James Pettet DPM PC Inc

  • Foot & Ankle Surgery Podiatrist
  • Littleton, CO
National Provider Identifier
1053409409
Registry record updated Jan 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
450 Issued in CO
Legal business name
JAMES PETTET DPM PC INC
Practice address
151 W Mineral Ave Ste 110
Littleton, CO 80120-4510
Phone
(303) 730-2955
Fax
(303) 798-7037
NPI assigned
Oct 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2009

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

Authorized official

Name
James Pettet, DPMNPI 1902867450
Title
Owner
Phone
(303) 730-2955

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X 450 CO Primary

Addresses

Primary practice location

151 W Mineral Ave Ste 110
Littleton, CO 80120-4510

Mailing address

151 W Mineral Ave Ste 110
Littleton, CO 80120-4510
Phone (303) 730-2955

Other identifiers 2

IdentifierTypeStateIssuer
DN2228OtherCORAILROAD MEDICARE GROUP PTAN
01004506MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040324000091 CO Part B Supplier - Clinic/Group Practice 0345131702 Receives reassigned benefits from 1 practitioner
Practice locations: Littleton, CO

National Provider Directory

National Provider Directory

Locations

151 W Mineral Ave
Ste 110
Littleton, CO 80120
Phone (303) 730-2955

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231372800000",
    "number": "1053409409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 W MINERAL AVE STE 110",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801204510",
            "telephone_number": "303-730-2955",
            "fax_number": "303-798-7037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 W MINERAL AVE STE 110",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801204510",
            "telephone_number": "303-730-2955",
            "fax_number": "303-798-7037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMES PETTET DPM PC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2009-01-08",
        "status": "A",
        "authorized_official_last_name": "PETTET",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "303-730-2955",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CO",
            "license": "450",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP PTAN",
            "identifier": "DN2228",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01004506",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Littleton, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.