NPIMap

Organization Active NPI

Robert H and Teresita S Petty

Doing business as Crossroads Anesthesia

  • Anesthesiology Physician
  • Effingham, IL
National Provider Identifier
1306913868
Registry record updated Feb 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
ROBERT H AND TERESITA S PETTY
Doing business as
Crossroads Anesthesia
Practice address
904 W Temple Ave
Effingham, IL 62401-2178
Phone
(217) 342-1234
Fax
(816) 461-6586
NPI assigned
Nov 29, 2006
Last updated
Feb 11, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2008

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

Authorized official

Name
Robert H Petty, MDNPI 1841259744
Title
President
Phone
(217) 342-1234

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X NU Primary

Addresses

Primary practice location

904 W Temple Ave
Effingham, IL 62401-2178

Mailing address

PO Box 1660
Independence, MO 64055-0660
Phone (816) 461-8288

Other names 1

  • CROSSROADS ANESTHESIA Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 42

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 42

NPI Registry JSON

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202688000000",
    "number": "1306913868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1660",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640550660",
            "telephone_number": "816-461-8288",
            "fax_number": "816-461-6586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 W TEMPLE AVE",
            "city": "EFFINGHAM",
            "state": "IL",
            "postal_code": "624012178",
            "telephone_number": "217-342-1234",
            "fax_number": "816-461-6586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT H AND TERESITA S PETTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-29",
        "last_updated": "2008-02-11",
        "status": "A",
        "authorized_official_last_name": "PETTY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "217-342-1234",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CROSSROADS ANESTHESIA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Effingham, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2008; 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.