Active NPI
Theresa Pettaway, PCD,DONA
- Doula
- Drexel Hill, PA
National Provider Identifier
1447784236
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Doula
- License
- 18087
- Practice address
- 624 Mason Ave
Drexel Hill, PA 19026-2430 - Phone
- (610) 553-5481
- Fax
- (610) 553-5482
- NPI assigned
- Apr 18, 2017
- Last updated
- Jul 10, 2025
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | |||
| Doula | 374J00000X | 18087 | PA | Primary |
Addresses
Primary practice location
624 Mason Ave
Drexel Hill, PA 19026-2430
Mailing address
624 Mason Ave
Drexel Hill, PA 19026-2430
Phone (610) 553-5481
Other practice location 1
7408 W Chester Pike
Upper Darby, PA 19082-2006
Phone (610) 553-5481
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18087 | PA | MD | Doula |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pettaway Pursuit Foundation | Doula | Current | Accepting new patients |
Locations
7408 W Chester Pike
Upper Darby, PA 19082
Phone (610) 553-5481
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1492473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1752105600000",
"number": "1447784236",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "624 MASON AVE",
"city": "DREXEL HILL",
"state": "PA",
"postal_code": "190262430",
"telephone_number": "610-553-5481",
"fax_number": "610-553-5482"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "624 MASON AVE",
"city": "DREXEL HILL",
"state": "PA",
"postal_code": "190262430",
"telephone_number": "610-553-5481",
"fax_number": "610-553-5482"
}
],
"practiceLocations": [
{
"address_1": "7408 W Chester Pike",
"address_purpose": "LOCATION",
"city": "Upper Darby",
"state": "PA",
"postal_code": "190822006",
"country_code": "US",
"telephone_number": "610-553-5481",
"fax_number": "610-553-5482",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PETTAWAY",
"first_name": "THERESA",
"credential": "PCD,DONA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-04-18",
"last_updated": "2025-07-10",
"certification_date": "2025-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": null,
"license": null,
"primary": false
},
{
"code": "374J00000X",
"taxonomy_group": "",
"desc": "Doula",
"state": "PA",
"license": "18087",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Drexel Hill, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.