Individual provider Active NPI

Joshua Robert Pettit, PA

  • Physician Assistant
  • Johnson City, TN
National Provider Identifier
1336072628
Registry record updated Jun 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2410 Susannah St
Johnson City, TN 37601-1748
Phone
(423) 282-9011
Fax
(423) 282-0035
NPI assigned
Jun 5, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

2410 Susannah St
Johnson City, TN 37601-1748

Mailing address

2410 Susannah St
Johnson City, TN 37601-1748
Phone (423) 282-9011

Other practice location 1

340 Steeles Rd
Bristol, TN 37620-9532
Phone (423) 282-9011

Other practice location 2

1132 Erwin Hwy
Greeneville, TN 37745-4405
Phone (423) 282-9011

Other practice location 3

875 Larry Neil Way
Kingsport, TN 37660-6368
Phone (423) 282-9011

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2026
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2410 Susannah St
Johnson City, TN 37601-1748

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Watauga Orthopaedics, PLC Physician Assistant PastSince Jun 30, 2024 Accepting new patients
Watauga Orthopaedics PLC Physician Assistant PastSince Jan 1, 2025 Accepting new patients

Organizations & group practices 2

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": "1780617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780617600000",
    "number": "1336072628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2410 SUSANNAH ST",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376011748",
            "telephone_number": "423-282-9011",
            "fax_number": "423-282-0035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2410 SUSANNAH ST",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376011748",
            "telephone_number": "423-282-9011",
            "fax_number": "423-282-0035"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "340 Steeles Rd",
            "address_purpose": "LOCATION",
            "city": "Bristol",
            "state": "TN",
            "postal_code": "376209532",
            "country_code": "US",
            "telephone_number": "423-282-9011",
            "fax_number": "423-282-0035",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1132 Erwin Hwy",
            "address_purpose": "LOCATION",
            "city": "Greeneville",
            "state": "TN",
            "postal_code": "377454405",
            "country_code": "US",
            "telephone_number": "423-282-9011",
            "fax_number": "423-282-0035",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "875 Larry Neil Way",
            "address_purpose": "LOCATION",
            "city": "Kingsport",
            "state": "TN",
            "postal_code": "376606368",
            "country_code": "US",
            "telephone_number": "423-282-9011",
            "fax_number": "423-282-0035",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETTIT",
        "first_name": "JOSHUA",
        "middle_name": "ROBERT",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-06-05",
        "last_updated": "2026-06-05",
        "certification_date": "2026-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.