Kertonnia Petty-Miliken

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

2570 Mockingbird LN
Florissant, MO 63031-3611

Phone

(314) 666-4041

NPI assigned

May 2, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Kertonnia Petty-Miliken Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Guardian of Love Home Healthcare, LLC

  • Case Manager/Care Coordinator
  • Florissant, MO
  • NPI 1396359204
  NPD Authorized official
• Perpend Counseling Service, LLC

  • Professional Counselor
  • Florissant, MO
  • NPI 1366057291
  NPD Authorized official

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

{
    "created_epoch": "1588377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599523200000",
    "number": "1134740004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 37092",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631411592",
            "telephone_number": "314-666-4041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2570 MOCKINGBIRD LN",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630313611",
            "telephone_number": "314-666-4041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTY-MILIKEN",
        "first_name": "KERTONNIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-02",
        "last_updated": "2020-09-08",
        "certification_date": "2020-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KERTONNIA",
            "last_name": "PETTY-MILIKEN",
            "prefix": "MS.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Golden Peters, PHARM.D
• Nicole Marie Petersen, PHARM.D.
• Todd J Petersen, PA-C
• Allison Elizabeth Pettibone, MSW, LMSW
• Julie Pettit, PHARM D
• Lyra Rivera Phan, PT
• Phases of Care in-Home Services, LLC
• Phases of Care LLC
• Rachel Miller Philippone, L.P.C.
• Nicole A Phillips, FNP

• Case Manager/Care Coordinator in Florissant, MO
• Providers in Florissant, MO by specialty
• Case Manager/Care Coordinator in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.