Individual provider Active NPI

Carmela Amelia Pettigrew, MD

  • Obstetrics & Gynecology Physician
  • Savannah, GA
National Provider Identifier
1295814432
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
43109 Issued in GA
Practice address
5311 Paulsen Street
Savannah, GA 31416
Phone
(912) 355-7766
Fax
(912) 352-7136
NPI assigned
Nov 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 43109 GA Primary

Addresses

Primary practice location

5311 Paulsen Street
Savannah, GA 31416

Mailing address

PO Box 13647
5311 Paulsen Street
Savannah, GA 31416
Phone (912) 355-7766

Other identifiers 1

IdentifierTypeStateIssuer
43109OtherGALICENSE #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20120104000143 GA Practitioner - Obstetrics/Gynecology 4981870516 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Southern California Keck School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
OBGYN Center PCGroup PAC ID 6103815121, 2 clinicians

Practice addresses (Care Compare)

600 E 70TH St
Savannah, GA 31405-4809
Phone (912) 355-7766

Hospital & facility affiliations

  • Candler Hospital Hospital, Savannah, GA, CCN 110024

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
43109GAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vanguard Medical Current Accepting new patients
OBGYN Center PC Obstetrics & Gynecology CurrentSince Apr 16, 2016 Accepting new patients
C. G. Melton, M.D.,P.a. Obstetrics & Gynecology Past Accepting new patients
Southeastern OB/GYN Center LLC Obstetrics & Gynecology Past Accepting new patients

Locations

600 E 70th St
Savannah, GA 31405
Phone (912) 355-7766

5311 Paulsen St
Savannah, GA 31405
Phone (912) 355-1111

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1295814432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13647",
            "address_2": "5311 PAULSEN STREET",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "31416",
            "telephone_number": "912-355-7766",
            "fax_number": "912-352-7136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5311 PAULSEN STREET",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "31416",
            "telephone_number": "912-355-7766",
            "fax_number": "912-352-7136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTIGREW",
        "first_name": "CARMELA",
        "middle_name": "AMELIA",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-06",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "43109",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE #",
            "identifier": "43109",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.