Persida L Petca, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

199089 Issued in GA

Practice address

58 Big a Road
Toccoa, GA 30577-6000

Phone

(706) 886-3148

Fax

(706) 886-3843

NPI assigned

Aug 24, 2011

Last updated

Aug 24, 2011By the provider in NPPES

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Fast Care Clinic Corporation

  • Family Medicine Physician
  • Buford, GA
  • NPI 1255603684
  NPD (past)

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

{
    "created_epoch": "1314144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314144000000",
    "number": "1720368681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58 BIG A ROAD",
            "city": "TOCCOA",
            "state": "GA",
            "postal_code": "305776000",
            "telephone_number": "706-886-3148",
            "fax_number": "706-886-3843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58 BIG A ROAD",
            "city": "TOCCOA",
            "state": "GA",
            "postal_code": "305776000",
            "telephone_number": "706-886-3148",
            "fax_number": "706-886-3843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETCA",
        "first_name": "PERSIDA",
        "middle_name": "L",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-24",
        "last_updated": "2011-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "199089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dawn Payne, MSPT
• Mallory Peavy, PT, DPT
• William Joseph Pendergrast, PHARM.D.
• Personal Assistance
• Personal Assistance of Toccoa, LLC
• Tara Joy Peters, LMSW
• Elizabeth Williams Pinkerton, M.D.
• Pittard Clinic LLC
• Cynthia League Poole, PHYSICAL THERAPIST
• Richard Clayton Power, PT, DPT

• Family Nurse Practitioner in Toccoa, GA
• Providers in Toccoa, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2011; 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.

Verify at the official NPI Registry.