Michael Logan Pettus, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

202000739 Issued in NC

Practice address

9735 Kincey Ave Ste 100
Huntersville, NC 28078-9120

Phone

(704) 500-2332

NPI assigned

Apr 14, 2014

Last updated

Feb 29, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

AnesthesiologyAlso: Pain Management

Education

University of South Carolina School of Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sarmc Anesthesia Specialist LLCGroup PAC ID 5294032413, 48 clinicians

East Carolina Anesthesia Associates PLLCGroup PAC ID 5092720813, 691 clinicians

Caromont Medical Group IncGroup PAC ID 3577476258, 425 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Caromont Regional Medical Center Hospital, Gastonia, NC, CCN 340032
• Sentara Albemarle Medical Center Hospital, Elizabeth City, NC, CCN 340109

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mpettus664238@direct.medicine.duke.edu

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.

• Caromont Medical Group Inc

  • Family Medicine Physician
  • Gastonia, NC
  • NPI 1356314272
  Medicare reassignment Care Compare group NPD
• East Carolina Anesthesia Associates, PLLC

  • Anesthesiology Physician
  • Greenville, NC
  • NPI 1205996519
  Medicare reassignment Care Compare group NPD
• Sarmc Anesthesia Specialist LLC

  • Critical Care Medicine (Anesthesiology) Physician
  • Elizabeth City, NC
  • NPI 1295194397
  Medicare reassignment Care Compare group NPD
• Carolinas Pain Center PLLC

  • Pain Medicine (Anesthesiology) Physician
  • Huntersville, NC
  • NPI 1912292335
  Medicare reassignment NPD
• Providence Anesthesiology Associates, P.a.

  • Anesthesiology Physician
  • Charlotte, NC
  • NPI 1396739884
  Medicare reassignment NPD
• Caromont Medical Group Inc

  • Family Medicine Physician
  • Stanley, NC
  • NPI 1972301380
  NPD
• Caromont Medical Group, Inc.

  dba CaroMont Inpatient Physicians

  • Hospitalist Physician
  • Gastonia, NC
  • NPI 1912188939
  NPD

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

• Gaston Memorial Hospital, Incorporated

  dba CaroMont Regional Medical Center

  • General Acute Care Hospital
  • Gastonia, NC
  • NPI 1013918960
  Care Compare affiliation
• Sentara Albemarle Regional Medical Center

  dba Sentara Albemarle Medical Center

  • General Acute Care Hospital
  • Elizabeth City, NC
  • NPI 1245211168
  Care Compare affiliation

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

{
    "created_epoch": "1397433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709164800000",
    "number": "1376962712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9735 KINCEY AVE STE 100",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280789120",
            "telephone_number": "704-500-2332",
            "fax_number": "704-274-2048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9735 KINCEY AVE STE 100",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280789120",
            "telephone_number": "704-500-2332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTUS",
        "first_name": "MICHAEL",
        "middle_name": "LOGAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-14",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NC",
            "license": "202000739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jose Raul Pena, M.D.
• Reba Alanna Pendleton, LCSW
• Keilee Perez-Diggs
• Perfecting Peace Counseling Center
• Uma Periyanayagam, M.D
• Jacita Booker Petway, PSY.D.
• Alycia Lynn Pfeiffer, DPT
• Teresa Thi Phan, PA
• Kaitlin Anne Phelps
• Olivia Catherine Philippart, PHARMD, BCTXP

• Anesthesiology Physician in Huntersville, NC
• Providers in Huntersville, NC by specialty
• Anesthesiology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.