Carrie Leigh Pettey, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

48509 Issued in MN

Practice address

347 N Smith Avenue 302
Childrens Primary Clinic STPL
St. Paul, MN 55102

Phone

(651) 220-6789

Fax

(651) 220-6807

NPI assigned

Aug 18, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Central Pediatrics, P.a.

  • Primary Care Clinic/Center
  • Woodbury, MN
  • NPI 1396721387
  NPD (past)
• Children'S Health Care

  • Primary Care Clinic/Center
  • Minneapolis, MN
  • NPI 1689852071
  NPD (past)
• Pediatric Surgical Associates LTD

  • Pediatric Surgery Physician
  • Minneapolis, MN
  • NPI 1093778292
  NPD (past)

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275647471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2910 CENTRE POINTE DR 35-121A",
            "address_2": "CHILDRENS HEALTH CARE",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "55113",
            "telephone_number": "651-855-2327",
            "fax_number": "651-855-2310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "347 N SMITH AVENUE 302",
            "address_2": "CHILDRENS PRIMARY CLINIC STPL",
            "city": "ST. PAUL",
            "state": "MN",
            "postal_code": "55102",
            "telephone_number": "651-220-6789",
            "fax_number": "651-220-6807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTEY",
        "first_name": "CARRIE",
        "middle_name": "LEIGH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "48509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Joy Petrangelo, RN
• Chase Eugene Petron, DC
• Kailee Anne Winkle Petrosky
• Teresa Petruccelli
• Laura K Petry, CPNP
• Robin Diane Pettit, RN,PHN
• Anthony J Pfaff, MD
• Caitlin Ariel Pfaff, LADC
• Kathleen M Pfaffinger, PHD LP
• Ryan Pfannenstein, DPM

• Pediatrics Physician in St. Paul, MN
• Providers in St. Paul, MN by specialty
• Pediatrics Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.