The Pettis Group, LLC

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

Legal business name

THE PETTIS GROUP, LLC

Practice address

3119 W Cochise Dr
Unit 154
Phoenix, AZ 85051

Phone

(602) 960-4886

Fax

(602) 960-4876

NPI assigned

Nov 8, 2021

Last updated

Nov 8, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Damon Knighton

Title

Owner

Phone

(480) 495-1776

Specialties & licenses 1

Addresses

Other names 1

• Pettis Group, LLC Other name

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

{
    "created_epoch": "1636329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636329600000",
    "number": "1275298960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2942 N 24TH ST STE 114",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167849",
            "telephone_number": "602-960-4886",
            "fax_number": "602-960-4876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3119 W COCHISE DR",
            "address_2": "UNIT 154",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85051",
            "telephone_number": "602-960-4886",
            "fax_number": "602-960-4876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PETTIS GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-08",
        "last_updated": "2021-11-08",
        "certification_date": "2021-10-15",
        "status": "A",
        "authorized_official_last_name": "KNIGHTON",
        "authorized_official_first_name": "DAMON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-495-1776"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pettis Group, LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Providers in Phoenix, AZ by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2021; 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.