Elizabeth Ann Petitt, NURSE PRACTITIONER

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

2011014335 Issued in OH

Practice address

8301 Detroit Ave
Cleveland, OH 44102-1805

Phone

(216) 281-2660

NPI assigned

Jul 9, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: epetitt243299@direct.ochin.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.

• Circle Health Services

  • Federally Qualified Health Center (FQHC)
  • Cleveland, OH
  • NPI 1386609857
  Medicare reassignment NPD
• Circle Health Services

  • Federally Qualified Health Center (FQHC)
  • Cleveland, OH
  • NPI 1396552949
  NPD
• Circle Health Services

  • Federally Qualified Health Center (FQHC)
  • Cleveland, OH
  • NPI 1568978948
  NPD (past)

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

{
    "created_epoch": "1278633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721952000000",
    "number": "1518279348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2202 PRAME AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441091626",
            "telephone_number": "216-281-2660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8301 DETROIT AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441021805",
            "telephone_number": "216-281-2660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETITT",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-09",
        "last_updated": "2024-07-26",
        "certification_date": "2024-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "F1209224",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "2011014335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mikayla E Peterson
• Ninoska Debraganza Peterson, PHD
• Olivia Peterson, S.T.N.A.
• Staci Peterson
• Daniel E Petery
• Jennifer Ann Petitt, CNP
• Jordan Cole Petitt, MD
• Bridget Petitti, SLP
• Laura Petiya, WHNP-BC
• Daniel Scott Petkovsek, M.D.

• Psychiatric/Mental Health Nurse Practitioner in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Psychiatric/Mental Health Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2024; 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.