Individual provider Active NPI

Coretta E Pitters, CRNP

  • Pediatric Nurse Practitioner
  • Montgomery, AL
National Provider Identifier
1356585947
Registry record updated Mar 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
1-059430 Issued in AL
Practice address
1845 Cherry St
Montgomery, AL 36107-2613
Phone
(334) 420-5001
Fax
(334) 420-0160
NPI assigned
Apr 27, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 1-059430 AL Primary

Addresses

Primary practice location

1845 Cherry St
Montgomery, AL 36107-2613

Mailing address

PO Box 70365
Montgomery, AL 36107-0365
Phone (334) 420-5038

Other practice location 1

2611 Woodley Park Dr
Montgomery, AL 36116-3834
Phone (334) 288-0009

Other identifiers 1

IdentifierTypeStateIssuer
1-059430OtherALALABAMA BOARD OF NURSING

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230818000270 AL Practitioner - Nurse Practitioner 3678935962 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Health Services, Inc. CurrentSince Jul 11, 2023 Accepting new patients
Health Services Inc CurrentSince Jul 11, 2023 Accepting new patients
Health Services Inc Current Accepting new patients
Health Services Inc CurrentSince Jul 11, 2023 Accepting new patients

Locations

203 N Taylor St
Autaugaville, AL 36003
Phone (334) 263-2301

511 E Tuskeena St
Hayneville, AL 36040
Phone (334) 548-2516

33 Salem Rd
#2
Montevallo, AL 35115

2611 Woodley Park Dr
Montgomery, AL 36116
Phone (334) 288-0009

3058 Mobile Hwy
Montgomery, AL 36108
Phone (334) 293-6670

Interoperability endpoints

  • Direct secure messaging: coretta.pitters.2@14429.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1240790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742947200000",
    "number": "1356585947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70365",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361070365",
            "telephone_number": "334-420-5038",
            "fax_number": "334-420-0158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1845 CHERRY ST",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361072613",
            "telephone_number": "334-420-5001",
            "fax_number": "334-420-0160"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2611 Woodley Park Dr",
            "address_purpose": "LOCATION",
            "city": "Montgomery",
            "state": "AL",
            "postal_code": "361163834",
            "country_code": "US",
            "telephone_number": "334-288-0009",
            "fax_number": "334-288-1441",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PITTERS",
        "first_name": "CORETTA",
        "middle_name": "E",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-27",
        "last_updated": "2025-03-26",
        "certification_date": "2025-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "AL",
            "license": "1-059430",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALABAMA BOARD OF NURSING",
            "identifier": "1-059430",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

Verify at the official NPI Registry.