Organization Active NPI

John a. Pettit, O.D.

  • Optometrist
  • Sarasota, FL
National Provider Identifier
1225290208
Registry record updated Jun 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
JOHN A. PETTIT, O.D.
Practice address
3920 Bee Ridge Rd
BLDG. a Suite a
Sarasota, FL 34233-1207
Phone
(941) 923-3411
Fax
(941) 921-3832
NPI assigned
Jun 30, 2008
Last updated
Jun 30, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2008

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

Authorized official

Name
Dr. John A. Pettit, OD
Title
Owner
Phone
94192133411

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU Primary

Addresses

Primary practice location

3920 Bee Ridge Rd
BLDG. a Suite a
Sarasota, FL 34233-1207

Mailing address

3920 Bee Ridge Rd
BLDG. a Suite a
Sarasota, FL 34233-1207
Phone (941) 923-3411

Other identifiers 1

IdentifierTypeStateIssuer
086943100MedicaidFL

National Provider Directory

National Provider Directory

Locations

3920 Bee Ridge Rd
Ste A-A
Sarasota, FL 34233
Phone (941) 867-7463

NPI Registry JSON

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

{
    "created_epoch": "1214784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214784000000",
    "number": "1225290208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3920 BEE RIDGE RD",
            "address_2": "BLDG. A SUITE A",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342331207",
            "telephone_number": "941-923-3411",
            "fax_number": "941-921-3832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3920 BEE RIDGE RD",
            "address_2": "BLDG. A SUITE A",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342331207",
            "telephone_number": "941-923-3411",
            "fax_number": "941-921-3832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN A. PETTIT, O.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-30",
        "last_updated": "2008-06-30",
        "status": "A",
        "authorized_official_last_name": "PETTIT",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "94192133411",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "086943100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2008; 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.