Active NPI
Chelsey Pettis
- Family Nurse Practitioner
- Evergreen, AL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 1-098965
- Practice address
- 100 Edwina St
Evergreen, AL 36401-3319 - Phone
- (251) 578-0278
- Fax
- (251) 578-1055
- NPI assigned
- Sep 26, 2016
- Last updated
- Sep 26, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 1-098965 | AL | Primary |
Addresses
Primary practice location
100 Edwina St
Evergreen, AL 36401-3319
Mailing address
101 Crestview Ave
Evergreen, AL 36401-3333
Phone (251) 578-2480
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nes Tennessee Inc | Current | Accepting new patients | |
| Nes Tennessee Inc | Family | Current | Accepting new patients |
| Rural Urgent Care LLC | Current | Accepting new patients | |
| Rural Urgent Care LLC | Current | Accepting new patients |
Locations
2134 Douglas Ave
Brewton, AL 36426
Phone (251) 236-4026
1925 W Main St
#120
Centre, AL 35960
Phone (256) 677-4552
1725 Pine St
Montgomery, AL 36106
Phone (334) 293-8000
2022 2nd Ave E
Oneonta, AL 35121
Phone (205) 545-5090
315 W Hickory St
Sylacauga, AL 35150
Phone (256) 249-5000
7300 State Highway 121
Ste 370374
McKinney, TX 75070
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Urgent Care Clinic/Center
- Centre, AL
- NPI 1932586476
-
- Emergency Medicine Physician
- Monroeville, AL
- NPI 1013519230
-
dba MainStreet Family Care
- Rural Health Clinic/Center
- Eufaula, AL
- NPI 1588450316
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1474848000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1474848000000",
"number": "1346799871",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 CRESTVIEW AVE",
"city": "EVERGREEN",
"state": "AL",
"postal_code": "364013333",
"telephone_number": "251-578-2480",
"fax_number": "251-578-1055"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 EDWINA ST",
"city": "EVERGREEN",
"state": "AL",
"postal_code": "364013319",
"telephone_number": "251-578-0278",
"fax_number": "251-578-1055"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETTIS",
"first_name": "CHELSEY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-09-26",
"last_updated": "2016-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "AL",
"license": "1-098965",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Evergreen, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.