Angela Patrice Pettis, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

0024169705 Issued in VA

Practice address

1050 W Perimeter Rd
Andrews AFB, MD 20762-6601

Phone

(240) 857-8509

NPI assigned

Jan 30, 2008

Last updated

Dec 6, 2011By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Enrolled in DC, MD2 enrollments

Enrollment records 2

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

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.

• Medstar Medical Group II LLC

  • General Practice Physician
  • Baltimore, MD
  • NPI 1184046187

  DC

  Medicare reassignment Care Compare group NPD
• Medstar Medical Group Anesthesiology LLC

  dba MMG Anesthesiology LLC

  • Anesthesiology Physician
  • Baltimore, MD
  • NPI 1528578333

  DC

  Medicare reassignment NPD
• Waldorf Anesthesia Services LLC

  • Anesthesiology Physician
  • Waldorf, MD
  • NPI 1295199925

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Dominion Anesthesia, PLLC

  • Anesthesiology Physician
  • Arlington, VA
  • NPI 1073554952

  DC, Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Medstar Medical Group Anesthesiology LLC

  • Anesthesiology Physician
  • Washington, DC
  • NPI 1558976175
  NPD
• Medstar Medical Group II LLC

  • Diagnostic Radiology Physician
  • Washington, DC
  • NPI 1578302055
  NPD
• Medstar Medical Group II LLC

  • Internal Medicine Physician
  • Washington, DC
  • NPI 1376887844
  NPD (past)

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

{
    "created_epoch": "1201651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323129600000",
    "number": "1649457706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 FARMINGTON RD W",
            "city": "ACCOKEEK",
            "state": "MD",
            "postal_code": "206079767",
            "telephone_number": "301-292-3959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 W PERIMETER RD",
            "city": "ANDREWS AFB",
            "state": "MD",
            "postal_code": "207626601",
            "telephone_number": "240-857-8509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTIS",
        "first_name": "ANGELA",
        "middle_name": "PATRICE",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-30",
        "last_updated": "2011-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "0024169705",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MD",
            "license": "R153416",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Khayanga Shakilo Namasaka, M.D.
• National Vision, Inc.
• Thomas Augustine Neal II, M.D.
• Jayasree Patla, M.D.
• Johnathan A Paxton, IDMT
• Iudok Premoe, PNP
• John C. Pritchett, D.M.D.
• Gregory Thomas Rehe, M.D.
• Christopher Clement Rhoney, IDMT
• Brandi Alyssa Ritter, P.A.

• Certified Registered Nurse Anesthetist in Andrews AFB, MD
• Providers in Andrews AFB, MD by specialty
• Certified Registered Nurse Anesthetist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.