Brian E Petty, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2442 Issued in WI

Practice address

1 S Park St
Madison, WI 53715

Phone

(608) 287-2650

Fax

(608) 287-2550

NPI assigned

Apr 18, 2006

Last updated

May 1, 2009By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1145318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241136000000",
    "number": "1649235250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7974 UW HEALTH CT",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535625531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 S PARK ST",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "53715",
            "telephone_number": "608-287-2650",
            "fax_number": "608-287-2550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTY",
        "first_name": "BRIAN",
        "middle_name": "E",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-18",
        "last_updated": "2009-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WI",
            "license": "2442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Petrie, M.D.
• Rachel Lillian Petro, MD
• Karen Marie Petrow
• Joseph J Petrozzo, PAC
• Amanda Marie Petterson
• David William Petty, RPH
• Dominique Lawrence Petty
• Elizabeth Marie Petty, MD
• Matthew R Peverill, PHD
• Lynn M Peyton, LCSW

• Speech-Language Pathologist in Madison, WI
• Providers in Madison, WI by specialty
• Speech-Language Pathologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2009; 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.