John Adam Petty, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4185 Issued in NC

Practice address

1295 Old US 1
Suite F
Southern Pines, NC 28387

Phone

(910) 246-2099

Fax

(910) 246-2098

NPI assigned

Jan 20, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Specialty

Chiropractic

Education

New York Chiropractic College, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Petty Chiropractic, PLLC

  • Chiropractor
  • Southern Pines, NC
  • NPI 1922340447
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1295481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355788800000",
    "number": "1083919245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1295 OLD US 1",
            "address_2": "SUITE F",
            "city": "SOUTHERN PINES",
            "state": "NC",
            "postal_code": "28387",
            "telephone_number": "910-246-2099",
            "fax_number": "910-246-2098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1295 OLD US 1",
            "address_2": "SUITE F",
            "city": "SOUTHERN PINES",
            "state": "NC",
            "postal_code": "28387",
            "telephone_number": "910-246-2099",
            "fax_number": "910-246-2098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTY",
        "first_name": "JOHN",
        "middle_name": "ADAM",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-01-20",
        "last_updated": "2012-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "008477",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "4185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Penick Village Inc
• Chelsea Perez
• Rachel Pessagno, OTR/L
• Peterkin & Associates, Inc.
• Petty Chiropractic, PLLC
• Tam T Pham, RPH
• Douglas Anthony Phillips, CRNA
• Richard Blair Phinney, MD
• Physical Therapy of Southern Pines, LLC
• Leo Angelo Pilapil

• Chiropractor in Southern Pines, NC
• Providers in Southern Pines, NC by specialty
• Chiropractor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.