Active NPI
Shari Pettit
- Registered Dietitian
- Huntington, WV
National Provider Identifier
1205658929
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 991
- Practice address
- 105 Forest Park LN
Huntington, WV 25705-3605 - Phone
- (740) 591-3634
- NPI assigned
- Oct 25, 2024
- 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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 991 | WV | Primary |
Addresses
Primary practice location
105 Forest Park LN
Huntington, WV 25705-3605
Mailing address
105 Forest Park LN
Huntington, WV 25705-3605
Phone (740) 591-3634
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 991 | WV | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cloud Health Medical Group, P.a. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Internal Medicine Physician
- White Plains, NY
- NPI 1528744935
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1729814400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729814400000",
"number": "1205658929",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 FOREST PARK LN",
"city": "HUNTINGTON",
"state": "WV",
"postal_code": "257053605",
"telephone_number": "740-591-3634"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 FOREST PARK LN",
"city": "HUNTINGTON",
"state": "WV",
"postal_code": "257053605",
"telephone_number": "740-591-3634"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETTIT",
"first_name": "SHARI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-10-25",
"last_updated": "2024-10-25",
"certification_date": "2024-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "WV",
"license": "991",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Huntington, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.