Individual provider Active NPI

Denise Pettinger, FNP

  • Family Nurse Practitioner
  • Manchester, TN
National Provider Identifier
1609326024
Registry record updated Aug 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
36914 Issued in TN
Practice address
115 N Woodland St
Manchester, TN 37355-1573
Phone
(931) 954-5219
NPI assigned
Oct 10, 2016
Last updated
Aug 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 36914 TN Primary
Family Nurse Practitioner 363LF0000X 95005270 CA

Addresses

Primary practice location

115 N Woodland St
Manchester, TN 37355-1573

Mailing address

115 N Woodland St
Manchester, TN 37355-1573
Phone (931) 954-5219

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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

Enrollment IDStateProvider typePAC IDDetails
I20241114004505 TN Practitioner - Nurse Practitioner 6800159625 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Woodland Wellness IncGroup PAC ID 3678824927, 3 clinicians

Practice addresses (Care Compare)

115 N Woodland St
Manchester, TN 37355-1573
Phone (931) 954-5219

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75.98 of 100Reported as group
Quality
66.36
Improvement activities
40
Cost
81.59

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
36914TNMDFamily Medicine Physician
95005270CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Woodland Wellness, Inc CurrentSince Sep 1, 2024 Accepting new patients
Woodland Wellness, Inc CurrentSince Sep 1, 2024 Accepting new patients

Locations

115 N Woodland St
Manchester, TN 37355
Phone (931) 723-7904

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1476057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724889600000",
    "number": "1609326024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 N WOODLAND ST",
            "city": "MANCHESTER",
            "state": "TN",
            "postal_code": "373551573",
            "telephone_number": "931-954-5219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 N WOODLAND ST",
            "city": "MANCHESTER",
            "state": "TN",
            "postal_code": "373551573",
            "telephone_number": "931-954-5219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTINGER",
        "first_name": "DENISE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-10",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "36914",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95005270",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, TN

Sources for this page

Verify at the official NPI Registry.