Individual provider Active NPI

Anjana L Pettigrew, MD

  • Clinical Cytogenetics Physician
  • Lexington, KY
National Provider Identifier
1295790640
Registry record updated Mar 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cytogenetics PhysicianTaxonomy code 207SC0300X
License
26584 Issued in KY
Practice address
800 Rose Street
Lexington, KY 40536-0001
Phone
(859) 323-5425
NPI assigned
Apr 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2013

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Cytogenetics Physician 207SC0300X 26584 KY Primary
Maternal & Fetal Medicine Physician 207VM0101X 26584 KY
Cytopathology Physician 207ZC0500X 26584 KY
Pediatric Adolescent Medicine Physician 2080A0000X 26584 KY

Addresses

Primary practice location

800 Rose Street
Lexington, KY 40536-0001

Mailing address

2333 Alumni Park PLZ
Suite 200
Lexington, KY 40517-4012
Phone (859) 257-7910

Other identifiers 1

IdentifierTypeStateIssuer
64265846MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080417000422 KY Practitioner - Pediatric Medicine 1658459573 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
26584KYMDMaternal & Fetal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kentucky Medical Services Foundation, Inc CurrentSince May 1, 2008 Accepting new patients

Locations

800 Rose St
Lexington, KY 40536
Phone (859) 257-8562

2400 Greatstone Pt
Lexington, KY 40504
Phone (859) 257-9800

2333 Alumni Park Plz
Ste 200
Lexington, KY 40517

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.

NPI Registry JSON

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362355200000",
    "number": "1295790640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2333 ALUMNI PARK PLZ",
            "address_2": "SUITE 200",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405174012",
            "telephone_number": "859-257-7910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 ROSE STREET",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405360001",
            "telephone_number": "859-323-5425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTIGREW",
        "first_name": "ANJANA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-19",
        "last_updated": "2013-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207SC0300X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Cytogenetics",
            "state": "KY",
            "license": "26584",
            "primary": true
        },
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "KY",
            "license": "26584",
            "primary": false
        },
        {
            "code": "207ZC0500X",
            "taxonomy_group": "",
            "desc": "Pathology, Cytopathology",
            "state": "KY",
            "license": "26584",
            "primary": false
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "KY",
            "license": "26584",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64265846",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.