NPIMap

Organization Active NPI

Kevin R. Pett PHD

  • Acupuncturist
  • Bend, OR
National Provider Identifier
1508213893
Registry record updated May 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC01101 Issued in OR
Legal business name
KEVIN R. PETT PHD
Practice address
39 NW Louisiana Ave
Bend, OR 97703-3310
Phone
(541) 330-0334
Fax
(541) 330-6635
NPI assigned
May 17, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 17, 2016

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

Authorized official

Name
Dr. Kevin Richard Pett, PHD., DAOM, DOMNPI 1144671520
Title
PHD.
Phone
(703) 587-1244

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
AcupuncturistGroup: 193200000X MULTI-SPECIALTY GROUP 171100000X AC01101 OR Primary

Addresses

Primary practice location

39 NW Louisiana Ave
Bend, OR 97703-3310

Mailing address

3062 NW Kelly Hill CT
Bend, OR 97703-7023
Phone (703) 587-1244

National Provider Directory

National Provider Directory

Locations

39 NW Louisiana Ave
Bend, OR 97703
Phone (541) 330-0334

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1463443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463443200000",
    "number": "1508213893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3062 NW KELLY HILL CT",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977037023",
            "telephone_number": "703-587-1244",
            "fax_number": "541-330-6635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 NW LOUISIANA AVE",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977033310",
            "telephone_number": "541-330-0334",
            "fax_number": "541-330-6635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEVIN R. PETT PHD",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-17",
        "last_updated": "2016-05-17",
        "status": "A",
        "authorized_official_last_name": "PETT",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "PHD.",
        "authorized_official_telephone_number": "703-587-1244",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD., DAOM, DOM"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "AC01101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2016; 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.