David A Petty I, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

14-02387 Issued in KS

Practice address

2100 N Amidon Ave # S208
Wichita, KS 67203-2126

Phone

(316) 832-1116

Fax

(316) 832-1138

NPI assigned

Jan 9, 2017

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1483920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483920000000",
    "number": "1508302068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 N AMIDON AVE # S208",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672032126",
            "telephone_number": "316-832-1116",
            "fax_number": "316-832-1138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 N AMIDON AVE # S208",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672032126",
            "telephone_number": "316-832-1116",
            "fax_number": "316-832-1138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTY",
        "first_name": "DAVID",
        "middle_name": "A",
        "name_suffix": "I",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-01-09",
        "last_updated": "2017-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "KS",
            "license": "14-02387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Earl Petrie, MD
• Kevin T. Petrie, D.D.S.
• Janelle R Petrisor
• Juliana M Petro
• Mary Pettiette, OT
• Chelsea Peyton, AUD, CCC-A, FAAA
• Deena Lynn Pfanenstiel, RN
• Gary Pfanenstiel, REGISTERED NURSE
• Adam Lynn Pfannenstiel, D.C.
• Susan K Pfannenstiel, APRN

• Physical Therapy Assistant in Wichita, KS
• Providers in Wichita, KS by specialty
• Physical Therapy Assistant in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2017; 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.