Richard George Petty, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

MD052287L Issued in PA

Practice address

2430 Tucker Dr
BLDG a
Loganville, GA 30052-4390

Phone

(770) 554-8812

NPI assigned

Dec 1, 2008

Last updated

Dec 1, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Promedica, Inc.

  dba Promedica Psychiatry Group

  • Mental Health Counselor
  • Loganville, GA
  • NPI 1922036508
  NPD (past)
• Wilkes-Barre Behavioral Hospital Company LLC

  dba General Community Pharmacy

  • Long Term Care Pharmacy
  • Kingston, PA
  • NPI 1629050620
  NPD (past)

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

{
    "created_epoch": "1228089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228089600000",
    "number": "1730334079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2430 TUCKER DR",
            "address_2": "BLDG A",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300524390",
            "telephone_number": "770-554-8812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2430 TUCKER DR",
            "address_2": "BLDG A",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300524390",
            "telephone_number": "770-554-8812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTY",
        "first_name": "RICHARD",
        "middle_name": "GEORGE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-12-01",
        "last_updated": "2008-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "PA",
            "license": "AK000401L",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD052287L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Althea Tiggs Penn, BSPT
• Katherine Pennington, DPT
• Christopher Love Perkins, D.C.
• Personal Care EMS LLC
• Susan M Perz, LMFT
• Tammy Petty, P.T.
• Nicolas Thong Pham, MD
• Jayson B. Phelps, DPM
• Physiotherapy Associates Inc (Physio-Loganville)
• Piedmont Healthcare Encompass Health Eastside Rehab Hospital, LLC (Eastside Rehabilitation Hospital)

• Psychiatry Physician in Loganville, GA
• Providers in Loganville, GA by specialty
• Psychiatry Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2008; 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.