Active NPI
Timothy J Pettigrew, M.D.
- Internal Medicine Physician
- Brownsburg, IN
National Provider Identifier
1679683148
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 01038748A
- Practice address
- 557 Pit Road
Brownsburg, IN 46112 - Phone
- (317) 885-2700
- Fax
- (317) 988-5523
- NPI assigned
- Aug 30, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 01038748A | IN | Primary |
Addresses
Primary practice location
557 Pit Road
Brownsburg, IN 46112
Mailing address
550 N Meridian St Ste 114
Indianapolis, IN 46204-1208
Phone (317) 274-4402
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100120580 | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110510000696 | IN | Order and Referring Only - Internal Medicine | 1052361888 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01038748A | IN | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Major Hospital | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Acute Care Hospital
- Shelbyville, IN
- NPI 1174555692
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1653004800000",
"number": "1679683148",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "550 N MERIDIAN ST STE 114",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462041208",
"telephone_number": "317-274-4402",
"fax_number": "317-274-5168"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "557 PIT ROAD",
"city": "BROWNSBURG",
"state": "IN",
"postal_code": "46112",
"telephone_number": "317-885-2700",
"fax_number": "317-988-5523"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETTIGREW",
"first_name": "TIMOTHY",
"middle_name": "J",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-30",
"last_updated": "2022-05-20",
"certification_date": "2022-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IN",
"license": "01038748A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100120580",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brownsburg, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.