Julie Pettis, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F04170449 Issued in GA

Practice address

200 Industrial Blvd
Dublin, GA 31021-2981

Phone

(478) 274-3865

NPI assigned

Feb 8, 2017

Sex

Female

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

Enrolled in GA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Georgia Em-I Medical Services. LLC

  • Nurse Practitioner
  • Bremen, GA
  • NPI 1851569560
  Medicare reassignment NPD
• Acs Primary Care Physicians - Southeast PC

  • Emergency Medicine Physician
  • Myrtle Beach, SC
  • NPI 1861430555

  GA

  Medicare reassignment NPD
• Georgia Em-I Medical Services, LLC

  • Nurse Practitioner
  • Covington, GA
  • NPI 1255213005
  NPD

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

{
    "created_epoch": "1486512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541462400000",
    "number": "1740728823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3489 NEW BUCKEYE RD",
            "city": "WRIGHTSVILLE",
            "state": "GA",
            "postal_code": "310963770",
            "telephone_number": "478-609-4269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 INDUSTRIAL BLVD",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310212981",
            "telephone_number": "478-274-3865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTIS",
        "first_name": "JULIE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-08",
        "last_updated": "2018-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LS0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, School",
            "state": "GA",
            "license": "RN190687",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "F04170449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sheila Perkins, NP
• James D Peters, D.O.
• Valerie L Peters, MS, RD, LD
• Susan L Petrey, MA/CCCA
• Tiffany Sammons Petrey, AGACNP-BC
• April S Phillips, BSHA
• Karen Lord Phillips, PT
• Physician Consultants of Georgia Dublin (Dublin Vascular Center)
• Physicians Staffing Solutions
• Shannon Pickett

• Family Nurse Practitioner in Dublin, GA
• Providers in Dublin, 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 Nov 6, 2018; 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.