John C Petitt, M.D

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G52812 Issued in CA

Practice address

5075 S Bradley Rd
Suite 131
Santa Maria, CA 93455-5077

Phone

(805) 938-7444

Fax

(805) 938-7422

NPI assigned

Jan 13, 2009

Sex

Male

Sole proprietor

Yes

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 CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jpetitt713173@direct.memorialcare.org

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.

• Northeast Valley Health Corporation

  dba Van Nuys Adult Health Center

  • Federally Qualified Health Center (FQHC)
  • Van Nuys, CA
  • NPI 1629079009
  Medicare reassignment NPD
• Southern California Medical Center, Inc.

  • Community Health Clinic/Center
  • El Monte, CA
  • NPI 1225357114

  Family Medicine

  Medicare reassignment NPD
• Dap Health, Inc.

  dba DAP Health-Borrego Springs Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Borrego Springs, CA
  • NPI 1134144165

  Family Medicine

  NPD
• Northeast Valley Health Corporation

  dba Pediatric Health and Wic Center

  • Federally Qualified Health Center (FQHC)
  • Van Nuys, CA
  • NPI 1093716474
  NPD
• Northeast Valley Health Corporation

  dba SCV Dental and Wellness Center

  • Federally Qualified Health Center (FQHC)
  • Santa Clarita, CA
  • NPI 1548960834
  NPD
• Southern California Medical Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Long Beach, CA
  • NPI 1447865415
  NPD
• Southern California Medical Center, Inc.

  • Community Health Clinic/Center
  • Pico Rivera, CA
  • NPI 1932428828
  NPD

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

{
    "created_epoch": "1231804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231804800000",
    "number": "1497992432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4036 CEDARHURST DR APT 101",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934556412",
            "telephone_number": "805-406-0880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5075 S BRADLEY RD",
            "address_2": "SUITE 131",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934555077",
            "telephone_number": "805-938-7444",
            "fax_number": "805-938-7422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETITT",
        "first_name": "JOHN",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-01-13",
        "last_updated": "2009-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G52812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roneaka Ann Peters, SUDRC #21780
• Grace Ann Peterson, M.ED
• James Edward Peterson, D.C.
• Levi Peterson
• Linda Lou Peterson, IMF
• Carol Petrini, RN, PHN
• Allison Pfeifer
• Judy Ann Pfeiffer, RN
• Jessica Pham, OTR
• Minhha Thi Pham, RPH

• Family Medicine Physician in Santa Maria, CA
• Providers in Santa Maria, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2009; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.