Timothy William Pettitt, MD

Primary specialty

Pediatric Surgery PhysicianTaxonomy code 2086S0120X

License

13143R Issued in LA

Practice address

200 Henry Clay Ave
New Orleans, LA 70118

Phone

(504) 896-9868

Fax

(504) 896-9410

NPI assigned

Sep 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in LA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Louisiana State University School of Med in New Orleans Faculty Grou

  • Pediatrics Physician
  • New Orleans, LA
  • NPI 1932492626
  Medicare reassignment
• Lsuhsc New Orleans Physicians

  • Pediatrics Physician
  • New Orleans, LA
  • NPI 1447487145
  NPD (past)

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

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1144322421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HENRY CLAY AVE",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "70118",
            "telephone_number": "504-896-9868",
            "fax_number": "504-896-9410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HENRY CLAY AVE",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "70118",
            "telephone_number": "504-896-9868",
            "fax_number": "504-896-9410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTITT",
        "first_name": "TIMOTHY",
        "middle_name": "WILLIAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "LA",
            "license": "13143R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1558010",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Danielle E Petroni, LCSW-BACS
• Lauren Elizabeth Petry
• Thomas Petterson, MT-BC
• Brian L Pettiford, MD
• Tyler Pettigrew
• Cynthia L Pettus, M.ED., PLPC, NCC
• Camille Petty
• Petvet DX Lab Services LLC
• George Peyton
• Nathaniel L Peyton, M.D.

• Pediatric Surgery Physician in New Orleans, LA
• Providers in New Orleans, LA by specialty
• Pediatric Surgery Physician in Louisiana

• 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.