John D Pettinger, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

40867 Issued in WI

Practice address

10400 75TH St
Kenosha, WI 53142-7884

Phone

(262) 948-7385

NPI assigned

Jul 4, 2006

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Emergency Medicine of Racine SC

  • Emergency Medicine Physician
  • Mount Pleasant, WI
  • NPI 1598102717
  NPD (past)
• Racine Emergency Physicians, S.C.

  • Emergency Medicine Physician
  • Racine, WI
  • NPI 1184654121
  NPD (past)

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418256000000",
    "number": "1497785463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10400 75TH ST",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531427884",
            "telephone_number": "262-948-7385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10400 75TH ST",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531427884",
            "telephone_number": "262-948-7385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTINGER",
        "first_name": "JOHN",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2014-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "40867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen A Peterson, M.D.
• Kristopher Wyllis Peterson, DC
• Mark A Peterson, PA-C
• Matthew D Peterson, PA-C
• Tina Anne-Marie Peterson, D.C.
• Mary Pettit, RN
• Bethany Pfeiffer
• Elizabeth Pflug-Froh, PT
• PH Kenosha LLC
• Huong Pham, OTR

• Emergency Medicine Physician in Kenosha, WI
• Providers in Kenosha, WI by specialty
• Emergency Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.