Individual provider Active NPI

David Charles Pettigrew, M.D.

  • Pediatrics Physician
  • Asheville, NC
National Provider Identifier
1124037692
Registry record updated Aug 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
201501886 Issued in NC
Practice address
509 Biltmore Ave
Asheville, NC 28801
Phone
(828) 213-1740
Fax
(828) 213-1742
NPI assigned
Aug 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2018

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Critical Care Medicine Physician 2080P0203X ME91053 FL
Pediatrics Physician 208000000X 201501886 NC Primary
Critical Care Medicine (Anesthesiology) Physician 207LC0200X 201501886 NC
Pediatric Critical Care Medicine Physician 2080P0203X 2015-01886 NC
Pediatric Critical Care Medicine Physician 2080P0203X 70934 FL

Addresses

Primary practice location

509 Biltmore Ave
Asheville, NC 28801

Mailing address

50 Schenck Pkwy
Asheville, NC 28803-3499
Phone (828) 213-1740

Other identifiers 1

IdentifierTypeStateIssuer
270801900MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151117001827 NC Practitioner - Pediatric Medicine 6406809680 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
201501886NCMDPediatrics Physician
70934FLMDPediatric Critical Care Medicine Physician
ME91053FLMDPediatric Critical Care Medicine Physician
2015-01886NCMDPediatric Critical Care Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mission Health Community Multispecialty Providers, LLC CurrentSince Dec 1, 2018 Accepting new patients
Mission Health Community Multispecialty Providers, LLC Current Accepting new patients
Mission Community Anesthesiology Specialists LLC CurrentSince Dec 1, 2018 Accepting new patients

Locations

509 Biltmore Ave
Asheville, NC 28801
Phone (828) 213-2325

1 Hospital Dr
Asheville, NC 28801
Phone (828) 213-1994

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Interoperability endpoints

  • Direct secure messaging: dpettigrew71896@capefearvalley.direct-ci.com
  • Direct secure messaging: dpettigrew497862@direct.conehealth.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533600000000",
    "number": "1124037692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 SCHENCK PKWY",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288033499",
            "telephone_number": "828-213-1740",
            "fax_number": "828-213-1742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 BILTMORE AVE",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "28801",
            "telephone_number": "828-213-1740",
            "fax_number": "828-213-1742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTIGREW",
        "first_name": "DAVID",
        "middle_name": "CHARLES",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2018-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "FL",
            "license": "ME91053",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "201501886",
            "primary": true
        },
        {
            "code": "207LC0200X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Critical Care Medicine",
            "state": "NC",
            "license": "201501886",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "NC",
            "license": "2015-01886",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "FL",
            "license": "70934",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "270801900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Asheville, NC

Sources for this page

Verify at the official NPI Registry.