Rachelle Rae Petika, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

NP-14658 Issued in OH

Practice address

5100 E Broadway Blvd
Tucson, AZ 85711-3762

Phone

(520) 613-3001

Fax

(520) 613-3003

NPI assigned

Jun 20, 2013

Last updated

Aug 11, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

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

Specialty

Nurse Practitioner

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Archwell Health Professional Services of Arizona, LLC

  • Internal Medicine Physician
  • Mesa, AZ
  • NPI 1558026880
  Medicare reassignment NPD

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

{
    "created_epoch": "1371686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660176000000",
    "number": "1639518962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 WOODMONT BLVD STE 600",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372055250",
            "telephone_number": "615-314-6257",
            "fax_number": "615-692-0547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 E BROADWAY BLVD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857113762",
            "telephone_number": "520-613-3001",
            "fax_number": "520-613-3003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETIKA",
        "first_name": "RACHELLE",
        "middle_name": "RAE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-20",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "NP-14658",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0096235",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Raymond William Peterson Jr., DPM
• Shannon Lynn Peterson, RN
• Sharon Peterson, OD
• Shaun N Peterson, MD
• Spencer O'Brien Peterson, D.O.
• Andrew Thomas Petrak, DNP
• Jason Thomas Petras, MA, BCBA
• Lane Louise Petri, A/GNP
• Joseph Michael Petrick Jr., RPH
• Marden Petrie, PSY.D.

• Family Nurse Practitioner in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.