Active NPI
Nessa Loraine Petrie, BSC, RPH
- Pharmacist
- Anderson, SC
National Provider Identifier
1154628139
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 12816
- Practice address
- 1412 E Greenville St
Anderson, SC 29621-2003 - Phone
- (864) 224-8873
- NPI assigned
- Feb 28, 2011
- Last updated
- Feb 28, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 12816 | SC | Primary |
Addresses
Primary practice location
1412 E Greenville St
Anderson, SC 29621-2003
Mailing address
1412 E Greenville St
Anderson, SC 29621-2003
Phone (864) 224-8873
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12816 | SC | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1298851200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1298851200000",
"number": "1154628139",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1412 E GREENVILLE ST",
"city": "ANDERSON",
"state": "SC",
"postal_code": "296212003",
"telephone_number": "864-224-8873"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1412 E GREENVILLE ST",
"city": "ANDERSON",
"state": "SC",
"postal_code": "296212003",
"telephone_number": "864-224-8873"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETRIE",
"first_name": "NESSA",
"middle_name": "LORAINE",
"name_prefix": "Miss",
"credential": "BSC, RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-02-28",
"last_updated": "2011-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "SC",
"license": "12816",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Anderson, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.