Linda Ann Pettit, CLINICAL NURSE SPECI

Primary specialty

Adult Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0809X

License

NS03049 Issued in OH

Practice address

180 E Spring Valley Rd
B
Centerville, OH 45458-3803

Phone

(937) 291-1351

Fax

(937) 291-1719

NPI assigned

Oct 18, 2006

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Specialist

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• South Suburban Mental Health Group

  • Clinical Social Worker
  • Centerville, OH
  • NPI 1013963065
  NPD (past)

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063593523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 E SPRING VALLEY RD",
            "address_2": "STE B",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "454583803",
            "telephone_number": "937-291-1351",
            "fax_number": "937-291-1719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 E SPRING VALLEY RD",
            "address_2": "B",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "454583803",
            "telephone_number": "937-291-1351",
            "fax_number": "937-291-1719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTIT",
        "first_name": "LINDA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "CLINICAL NURSE SPECI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "OH",
            "license": "NS03049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charlemae Ava Perkins, DPT
• Rachel Jo Perretta, MS, RN, ACNS-BC
• Toni Peters, CNP
• Caroline E Peterson, DO
• Kim J Peterson, M.S., LPCC
• Dawn Lucille Phillips
• Katherine Phillips
• Shavonne Phillips, MSW, LSW
• Ralph A Pierce Jr.
• Tiffanie Ann Pinnix, BA LCDC III

• Adult Psychiatric/Mental Health Clinical Nurse Specialist in Centerville, OH
• Providers in Centerville, OH by specialty
• Adult Psychiatric/Mental Health Clinical Nurse Specialist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.