Sandra Pettigrew, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

R039549 Issued in SD

Practice address

East Highway 18
East Highway 18
Pine Ridge, SD 57770-1201

Phone

(605) 867-3313

Fax

(605) 867-3332

NPI assigned

Jun 24, 2014

Last updated

Jun 24, 2014By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

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.

• Pine Ridge Indian Health Service Hospital

  dba Pine Ridge IHS Hospital

  • General Acute Care Hospital
  • Pine Ridge, SD
  • NPI 1497786412
  NPD (past)
• Pine Ridge Indian Health Service Hospital

  dba Wanblee Health Center

  • Clinic/Center
  • Wanblee, SD
  • NPI 1962559518
  NPD (past)

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

{
    "created_epoch": "1403568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403568000000",
    "number": "1639584048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "EAST HIGHWAY 18",
            "city": "PINE RIDGE",
            "state": "SD",
            "postal_code": "577701201",
            "telephone_number": "605-867-3313",
            "fax_number": "605-867-3332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "EAST HIGHWAY 18",
            "address_2": "EAST HIGHWAY 18",
            "city": "PINE RIDGE",
            "state": "SD",
            "postal_code": "577701201",
            "telephone_number": "605-867-3313",
            "fax_number": "605-867-3332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTIGREW",
        "first_name": "SANDRA",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-24",
        "last_updated": "2014-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "SD",
            "license": "R039549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ost Ambulance Service
• Ost CHR Program
• Amy Nicole Passero, RN
• Tracy Lynn Pawnee Leggins, RN
• Stephanie Perez Rodriguez
• Forge Pham, PHARMD
• Pine Ridge IHS
• Pine Ridge IHS Hospital Pharmacy
• Pine Ridge Indian Health Service
• Pine Ridge Indian Health Service Hospital (Pine Ridge IHS Hospital)

• Registered Nurse in Pine Ridge, SD
• Providers in Pine Ridge, SD by specialty
• Registered Nurse in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2014; 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.