Janessia Chenelle Pettigrew, APRN, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

2024029307 Issued in MO

Practice address

3001 Warrior LN
Poplar Bluff, MO 63901-8685

Phone

(573) 686-1200

NPI assigned

Jul 18, 2022

Sex

Female

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 MO

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Family Counseling Center IncGroup PAC ID 2163410481, 39 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Family Counseling Center, Inc.

  • Community/Behavioral Health Agency
  • Kennett, MO
  • NPI 1669477550
  Medicare reassignment Care Compare group NPD
• Family Counseling Center, Inc.

  • Primary Care Clinic/Center
  • Poplar Bluff, MO
  • NPI 1235738493
  NPD

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

{
    "created_epoch": "1658102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722902400000",
    "number": "1437884137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 WARRIOR LN",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639018685",
            "telephone_number": "573-686-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 WARRIOR LN",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639018685",
            "telephone_number": "573-686-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTIGREW",
        "first_name": "JANESSIA",
        "middle_name": "CHENELLE",
        "name_prefix": "Miss",
        "credential": "APRN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-18",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MO",
            "license": "2024029307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy Paul Pennington, LCSW
• Julia Leeann Perryman
• Tiffany Persons
• Richard Pestillos, PT
• Rebecca Peters
• Suwan Phanijphand, MD
• Astasia Estell Phelps
• Daniel Travis Phillips, LCSW
• Darby Blake Phillips, FNP-C
• Mackenzie Phillips

• Psychiatric/Mental Health Nurse Practitioner in Poplar Bluff, MO
• Providers in Poplar Bluff, MO by specialty
• Psychiatric/Mental Health Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 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.