Joshua Van Pettit, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

R69821 Issued in AR

Practice address

3024 Stadium Blvd
Jonesboro, AR 72401-7415

Phone

(501) 227-0700

Fax

(501) 227-0744

NPI assigned

May 16, 2010

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

Enrolled in AR

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jonesboro Surgery Center AnesthesiaGroup PAC ID 0446532766, 3 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 and National Provider Directory roles.

• Jonesboro Surgery Center Anesthesia

  • Anesthesiology Physician
  • Jonesboro, AR
  • NPI 1558641548
  Medicare reassignment Care Compare group
• Lifelinc Anesthesia V, P.a.

  • Anesthesiology Physician
  • West Memphis, AR
  • NPI 1063907244

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• BP Anesthesia, PLLC

  • Certified Registered Nurse Anesthetist
  • Little Rock, AR
  • NPI 1942736285

  Nurse Anesthetist, Certified Registered

  NPD (past)

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

{
    "created_epoch": "1273968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273968000000",
    "number": "1679891527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2024 ARKANSAS VALLEY DR",
            "address_2": "SUITE 202",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722124166",
            "telephone_number": "501-227-0700",
            "fax_number": "501-227-0744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3024 STADIUM BLVD",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724017415",
            "telephone_number": "501-227-0700",
            "fax_number": "501-227-0744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTIT",
        "first_name": "JOSHUA",
        "middle_name": "VAN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-16",
        "last_updated": "2010-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AR",
            "license": "R69821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Personal Therapy of Northeast Arkansas, Inc.
• Amanda Marie Peters, COTA
• James Peters
• Lawrence Carlton Peters, CRNA
• Hannah Camille Pettit, MHPP
• Bruce Phelix
• Tybrina D Phelps
• Philcare Medical Supplies Inc.
• Angel Nicole Phillip, QBHP
• Amy Brooke Phillips, PSY D

• Certified Registered Nurse Anesthetist in Jonesboro, AR
• Providers in Jonesboro, AR by specialty
• Certified Registered Nurse Anesthetist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2010; 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.