Patricia Ann Pettis, APRN

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

031898-23 Issued in NH

Practice address

100 Shattuck Way Ste 100
Newington, NH 03801-8007

Phone

(603) 431-6677

Fax

(603) 610-2232

NPI assigned

Nov 15, 2021

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

Enrolled in NH

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/9362/brand/1/csg/1/fhir/r4

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.

• Whole Life Health Care, PA

  • Primary Care Nurse Practitioner
  • Newington, NH
  • NPI 1770646614
  Medicare reassignment NPD

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

{
    "created_epoch": "1636934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636934400000",
    "number": "1104582097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 SHATTUCK WAY STE 100",
            "city": "NEWINGTON",
            "state": "NH",
            "postal_code": "038018007",
            "telephone_number": "603-431-6677",
            "fax_number": "603-610-2232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SHATTUCK WAY STE 100",
            "city": "NEWINGTON",
            "state": "NH",
            "postal_code": "038018007",
            "telephone_number": "603-431-6677",
            "fax_number": "603-610-2232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTIS",
        "first_name": "PATRICIA",
        "middle_name": "ANN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-15",
        "last_updated": "2021-11-15",
        "certification_date": "2021-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "NH",
            "license": "031898-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Northeast Surgical Care of Newington, LLC
• Pain Surgery Center Limited Liability Company
• Travis Palmer, FNP-C
• Andrea Martin Parsons, M.ED., LCMHC
• Laura M. Peterson, LICSW
• Brianne Pileggi, MS BCBA
• Anna M Pilzer, NP
• Points North Recovery LLC
• Samara Ida Pottier-Taccetta, CNM, APRN
• Elizabeth Prior, RBT

• Pediatric Adolescent Medicine Physician in Newington, NH
• Providers in Newington, NH by specialty
• Pediatric Adolescent Medicine Physician in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2021; 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.