Active NPI
Dawn Michelle Pettus, PHARM.D.
- Pharmacist
- Greensboro, NC
National Provider Identifier
1598824781
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 13006
- Practice address
- 1200 N Elm St
Greensboro, NC 27401-1004 - Phone
- (336) 832-7244
- Fax
- (336) 832-2851
- NPI assigned
- Dec 6, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 13006 | NC | Primary |
Addresses
Primary practice location
1200 N Elm St
Greensboro, NC 27401-1004
Mailing address
103 Cedarwood Dr
Jamestown, NC 27282-9464
Phone (336) 454-3527
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13006 | NC | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1598824781",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "103 CEDARWOOD DR",
"city": "JAMESTOWN",
"state": "NC",
"postal_code": "272829464",
"telephone_number": "336-454-3527",
"fax_number": "336-832-2851"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 N ELM ST",
"city": "GREENSBORO",
"state": "NC",
"postal_code": "274011004",
"telephone_number": "336-832-7244",
"fax_number": "336-832-2851"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETTUS",
"first_name": "DAWN",
"middle_name": "MICHELLE",
"name_prefix": "Dr.",
"credential": "PHARM.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "13006",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greensboro, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.