Active NPI
Matthew Robert Petit, PHARMD
- Pharmacist
- Winnsboro, LA
National Provider Identifier
1700367307
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PST.022561
- Practice address
- 3360 Front St
Winnsboro, LA 71295-6487 - Phone
- (318) 453-9011
- NPI assigned
- Aug 22, 2018
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | PST.022561 | LA | Primary |
Addresses
Primary practice location
3360 Front St
Winnsboro, LA 71295-6487
Mailing address
3980 Old Sterlington Rd Apt 1604
Monroe, LA 71203-2690
Phone (504) 756-4642
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PST.022561 | LA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1534896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1534896000000",
"number": "1700367307",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3980 OLD STERLINGTON RD APT 1604",
"city": "MONROE",
"state": "LA",
"postal_code": "712032690",
"telephone_number": "504-756-4642"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3360 FRONT ST",
"city": "WINNSBORO",
"state": "LA",
"postal_code": "712956487",
"telephone_number": "318-453-9011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETIT",
"first_name": "MATTHEW",
"middle_name": "ROBERT",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-08-22",
"last_updated": "2018-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "LA",
"license": "PST.022561",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winnsboro, LA
- Robert Joseph Pasero, P.T.
- Pelican State Chiropractic LLC
- Drew Key Perry, P-LPC, MHP
- Jessica Williams Perry, FNP-C
- Shelia Katheleen Perry, FNP-BC
- Courtney Kemper Pickett, CCC-SLP
- Plantation Manor Nursing & Rehabilitation Center, LLC (Plantation Manor Nursing & Rehabilitation Center)
- Chad Thomas Porter, M.D.
- Powell Medical Transportation, LLC
- Pauline T Powell
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.