Deann Petitgout, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

00226 Issued in IA

Practice address

1550 Clarke Dr
Ms 1757
Dubuque, IA 52001-3117

Phone

(563) 588-6415

Fax

(563) 588-6666

NPI assigned

Mar 28, 2007

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720107980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 SHERWOOD AVE",
            "city": "EAST DUBUQUE",
            "state": "IL",
            "postal_code": "610251151",
            "telephone_number": "815-747-9922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 CLARKE DR",
            "address_2": "MS 1757",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520013117",
            "telephone_number": "563-588-6415",
            "fax_number": "563-588-6666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETITGOUT",
        "first_name": "DEANN",
        "name_prefix": "Mrs.",
        "credential": "LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IA",
            "license": "00226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Perreault
• Kimberly Ann Peterman, RD/LD,CDE
• Allison Lynn Peters
• Jennifer Marie Peters
• Rebecca Peterson, M.S.
• Kari Pfab, ARNP
• Paulina Phomvongsa, MD
• Emma Sue Piehl, RPH, PHARMD
• Stephen Eugene Pierotti, M.D.
• Molly Jae Pilcher, ATC

• Athletic Trainer in Dubuque, IA
• Providers in Dubuque, IA by specialty
• Athletic Trainer in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.