Individual provider Active NPI

Francis Christopher Pettigrew, MD

  • Plastic Surgery Physician
  • Pooler, GA
National Provider Identifier
1427044650
Registry record updated Jan 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
39904 Issued in GA
Practice address
1000 Towne Center Blvd Ste 501
Pooler, GA 31322-4061
Phone
(912) 988-1781
Fax
(912) 777-7591
NPI assigned
Sep 22, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 39904 GA Primary

Addresses

Primary practice location

1000 Towne Center Blvd Ste 501
Pooler, GA 31322-4061

Mailing address

1000 Towne Center Blvd Ste 501
Pooler, GA 31322-4061
Phone (912) 988-1781

Other identifiers 1

IdentifierTypeStateIssuer
00663715AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20181119001848 GA Practitioner - Plastic and Reconstructive Surgery 1052402971 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
University of Tennessee, HSC, College of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1000 Towne Ctr Blvd
Suite 501
Pooler, GA 31322-4061
Phone (912) 988-1781

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision125
Removal of skin lesions1-10
Skin biopsy25

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
39904GAMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pooler Plastic Surgery LLC Plastic Surgery Current Accepting new patients
Reflections Enterprises Plastic Surgery CurrentSince Jun 8, 2007 Accepting new patients

Locations

1000 Towne Center Blvd
Ste 501
Pooler, GA 31322
Phone (912) 330-5030

7208 Hodgson Memorial Dr
Savannah, GA 31406
Phone (912) 351-5050

Organizations & group practices 3

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": "1127347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673913600000",
    "number": "1427044650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 TOWNE CENTER BLVD STE 501",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313224061",
            "telephone_number": "912-988-1781",
            "fax_number": "912-777-7591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 TOWNE CENTER BLVD STE 501",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313224061",
            "telephone_number": "912-988-1781",
            "fax_number": "912-777-7591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTIGREW",
        "first_name": "FRANCIS",
        "middle_name": "CHRISTOPHER",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-22",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "GA",
            "license": "39904",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00663715A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pooler, GA

Sources for this page

Verify at the official NPI Registry.