Kyler Ray Pettry

Primary specialty

MechanotherapistTaxonomy code 172M00000X

License

MA58698 Issued in FL

Practice address

3800C SW 17TH Ave
Gainesville, FL 32607-4120

Phone

(352) 278-3625

NPI assigned

Mar 29, 2010

Last updated

Mar 29, 2010By the provider in NPPES

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

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": "1269820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269820800000",
    "number": "1548585979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800C SW 17TH AVE",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326074120",
            "telephone_number": "352-278-3625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800C SW 17TH AVE",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326074120",
            "telephone_number": "352-278-3625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTRY",
        "first_name": "KYLER",
        "middle_name": "RAY",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-03-29",
        "last_updated": "2010-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172M00000X",
            "taxonomy_group": "",
            "desc": "Mechanotherapist",
            "state": "FL",
            "license": "MA58698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tonya Pettiford, M.A.
• James C Pettigrew Jr., DMD
• Traci Pettigrew, A.P.
• Paul David Pettit
• Shannon Brown Pettit
• Mark A Petty, M.D.
• Roy W Petty, M.D.
• Patricia Marie Petzold, CRNA
• Curtis J Peyer, LMT
• Amy Lorraine Peyton

• Mechanotherapist in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Mechanotherapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2010; 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.