Organization Active NPI

F Christopher Pettigrew MD PC

  • Plastic and Reconstructive Surgery Physician
  • Pooler, GA
National Provider Identifier
1265912513
Registry record updated Jan 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
39904 Issued in GA
Legal business name
F CHRISTOPHER PETTIGREW MD PC
Practice address
1000 Towne Center Blvd Ste 501
Pooler, GA 31322-4061
Phone
(912) 988-1781
Fax
(912) 777-7591
NPI assigned
Aug 16, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2023

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

Authorized official

Name
Francis Christopher Pettigrew, MDNPI 1427044650
Title
Owner
Phone
(912) 988-1781

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086S0122X 39904 GA Primary

Addresses

Primary practice location

1000 Towne Center Blvd Ste 501
Pooler, GA 31322-4061

Mailing address

1000 Towne Center Blvd Ste 501
Pooler, GA 31322-4061
Phone (912) 988-1781

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181119001641 GA Part B Supplier - Clinic/Group Practice 8820342447 Receives reassigned benefits from 1 practitioner
Practice locations: Pooler, GA

National Provider Directory

National Provider Directory

Locations

1000 Towne Center Blvd
Ste 501
Pooler, GA 31322
Phone (912) 330-5030

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1534377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673913600000",
    "number": "1265912513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 TOWNE CENTER BLVD STE 501",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313224061",
            "telephone_number": "912-988-1781",
            "fax_number": "912-777-7591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 TOWNE CENTER BLVD STE 501",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313224061",
            "telephone_number": "912-988-1781",
            "fax_number": "912-777-7591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "F CHRISTOPHER PETTIGREW MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-16",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-17",
        "status": "A",
        "authorized_official_last_name": "PETTIGREW",
        "authorized_official_first_name": "FRANCIS",
        "authorized_official_middle_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "912-988-1781",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "GA",
            "license": "39904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pooler, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.