Active NPI
Deborah Anne Petteway, PHYSICIAN ASSISTANT
- Physician Assistant
- Sacramento, CA
National Provider Identifier
1184885733
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA15091
- Practice address
- 1 Scripps Drive
Suite 202
Sacramento, CA 95825 - Phone
- (916) 927-1114
- NPI assigned
- Jun 17, 2008
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA15091 | CA | Primary |
Addresses
Primary practice location
1 Scripps Drive
Suite 202
Sacramento, CA 95825
Mailing address
1 Scripps Drive
Suite 202
Sacramento, CA 95825
Phone (916) 927-1114
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX, AK
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
Locations
4315 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-1729
4320 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-0000
Interoperability endpoints
- dapetteway@direct.bbahc.org
Organizations & group practices 23
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.
-
- Critical Access Hospital
- Nome, AK
- NPI 1154358232
Physician Assistant
-
- Clinic/Center
- Koliganek, AK
- NPI 1013079607
-
- Clinic/Center
- Ekwok, AK
- NPI 1104988799
-
- Clinic/Center
- Pilot Point, AK
- NPI 1174683825
-
- Clinic/Center
- Platinum, AK
- NPI 1285796870
-
- Clinic/Center
- Levelock, AK
- NPI 1366502767
-
- Clinic/Center
- South Naknek, AK
- NPI 1417018193
-
- Clinic/Center
- Twin Hills, AK
- NPI 1487716825
-
- Clinic/Center
- Perryville, AK
- NPI 1528128782
-
- Clinic/Center
- Chignik Lagoon, AK
- NPI 1578623641
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213660800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1213660800000",
"number": "1184885733",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 SCRIPPS DRIVE",
"address_2": "SUITE 202",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "95825",
"telephone_number": "916-927-1114",
"fax_number": "916-927-3244"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 SCRIPPS DRIVE",
"address_2": "SUITE 202",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "95825",
"telephone_number": "916-927-1114"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETTEWAY",
"first_name": "DEBORAH",
"middle_name": "ANNE",
"name_prefix": "Ms.",
"credential": "PHYSICIAN ASSISTANT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-06-17",
"last_updated": "2008-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA15091",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2008; 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.