Michael Rand Pettit, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

17789 Issued in LA

Practice address

114 Gloria Dr
Lake Charles, LA 70611

Phone

(337) 314-9559

NPI assigned

Aug 16, 2010

Sex

Male

Sole proprietor

No

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

Credentials

Doctor of Pharmacy

State licenses

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 and National Provider Directory roles.

• Harrp Group LLC

  • Community/Retail Pharmacy
  • Moss Bluff, LA
  • NPI 1972122349
  NPD Authorized official
• Walgreen Co

  • Pharmacy
  • Deridder, LA
  • NPI 1427259852
  NPD (past)
• Walgreen Co

  • Pharmacy
  • Longview, TX
  • NPI 1629956545
  NPD (past)

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

{
    "created_epoch": "1281916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586995200000",
    "number": "1629383559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 GLORIA DR",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "70611",
            "telephone_number": "337-314-9559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 GLORIA DR",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "70611",
            "telephone_number": "337-314-9559"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "916 N Pine St",
            "address_purpose": "LOCATION",
            "city": "Deridder",
            "state": "LA",
            "postal_code": "706342816",
            "country_code": "US",
            "telephone_number": "337-462-2019",
            "fax_number": "337-462-2339",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETTIT",
        "first_name": "MICHAEL",
        "middle_name": "RAND",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-16",
        "last_updated": "2020-04-16",
        "certification_date": "2020-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "LA",
            "license": "17789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristie Pete, RN
• Kacie Webb Peterson, MA, CCC-L/SLP
• Linda R Peterson, OT
• Rebecca Caroline Pettefer, PLPC
• Christe Hester Pettis, M.A., CCC-SLP
• Robin P Pettit, PHARMD
• PGF Transportation LLC
• Tuananh Minh Pham, M.D.
• Pharma Fusion, LLC
• Caitlyn Pharris, DPT

• Pharmacist in Lake Charles, LA
• Providers in Lake Charles, LA by specialty
• Pharmacist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2020; 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.