Anthony Ray Pettry

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

214 S 4TH St
Ironton, OH 45638-1610

Phone

(740) 532-3767

Fax

(740) 532-3385

NPI assigned

Apr 22, 2022

Last updated

Nov 30, 2022By the provider in NPPES

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Spectrum Outreach Services, LTD

  • Community/Behavioral Health Agency
  • Ironton, OH
  • NPI 1013969666
  NPD
• Spectrum Outreach Services, LTD

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Ironton, OH
  • NPI 1699254300
  NPD (past)
• Jason a. Moore, D.C. PLLC

  dba Huntington Chiropractic Accident & Injury Clinic

  • Health Service Clinic/Center
  • Huntington, WV
  • NPI 1316168271
  NPD (past)
• Recovery Resource Group

  • Community/Behavioral Health Agency
  • Huntington, WV
  • NPI 1669066858
  NPD (past)

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

{
    "created_epoch": "1650585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669766400000",
    "number": "1609510064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1123 NORWAY AVE",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257052923",
            "telephone_number": "304-691-3330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 S 4TH ST",
            "city": "IRONTON",
            "state": "OH",
            "postal_code": "456381610",
            "telephone_number": "740-532-3767",
            "fax_number": "740-532-3385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTRY",
        "first_name": "ANTHONY",
        "middle_name": "RAY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-22",
        "last_updated": "2022-11-30",
        "certification_date": "2022-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "OH",
            "license": null,
            "primary": true
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "WV",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason L Perry, CDCA
• Jodie E Perry, CDCA
• Billie Jo Persinger
• Brandon L Peters, CDCA, QMHS
• Kendra Peters, CDCA
• Jaimie R Phillips, LISW
• Tonya Phillips
• Phoenix Center, Inc. (TPC Wellness)
• Phoenix Center, Inc. (TPC Wellness)
• Phoenix Center, Inc.

• Case Manager/Care Coordinator in Ironton, OH
• Providers in Ironton, OH by specialty
• Case Manager/Care Coordinator in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2022; 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.