Michael Travis Petty, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC511 Issued in TN

Practice address

10826 Kingston Pike
Knoxville, TN 37934-3059

Phone

(865) 675-5050

Fax

(865) 671-1321

NPI assigned

Jun 20, 2005

Sex

Male

Sole proprietor

Yes

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 TN

Enrollment records 1

Specialty

Chiropractic

Education

Life Chiropractic College, 1986

Medicare assignment

May accept Medicare assignment

Group practices

Michael T Petty DC PLLCGroup PAC ID 9931530714, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Michael T Petty DC PLLC

  • Multi-Specialty Clinic/Center
  • Knoxville, TN
  • NPI 1417200809
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1119225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358035200000",
    "number": "1679578132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10826 KINGSTON PIKE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379343059",
            "telephone_number": "865-675-5050",
            "fax_number": "865-671-1321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10826 KINGSTON PIKE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379343059",
            "telephone_number": "865-675-5050",
            "fax_number": "865-671-1321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTY",
        "first_name": "MICHAEL",
        "middle_name": "TRAVIS",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-20",
        "last_updated": "2013-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "DC511",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1811205",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jamie K Pettet
• Marianna Grace Pettit
• Tanner Matthew Pettit, MD
• Colton Ryan Petty, MD
• David Gordon Petty Jr., M.D.
• Samantha R Petty, APN, RN
• Mendy Pevahouse, FNP-BC
• Megan Marie Pfeifer
• Zachary Pfeil
• William T Pflanze, MD

• Chiropractor in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Chiropractor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2013; 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.