Manjula Rani Petchetti, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

2008-00313 Issued in NC

Practice address

105 Yadkin St
Suite 303
Albemarle, NC 28001-3449

Phone

(980) 323-5400

NPI assigned

May 2, 2008

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mpetchetti221486@direct.unc.nchie.net

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.

• Scotland Memorial Hospital Inc

  • Vascular Surgery Physician
  • Laurinburg, NC
  • NPI 1477791507
  Medicare reassignment NPD
• Vidant Medical Group LLC

  • Multi-Specialty Clinic/Center
  • Greenville, NC
  • NPI 1477648731
  Medicare reassignment
• Scotland Memorial Hospital Inc

  • General Practice Physician
  • Laurinburg, NC
  • NPI 1518951144

  Pediatrics

  NPD

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

{
    "created_epoch": "1209686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635206400000",
    "number": "1760658447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 YADKIN ST",
            "city": "ALBEMARLE",
            "state": "NC",
            "postal_code": "280013449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 YADKIN ST",
            "address_2": "SUITE 303",
            "city": "ALBEMARLE",
            "state": "NC",
            "postal_code": "280013449",
            "telephone_number": "980-323-5400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "850 S Main St",
            "address_purpose": "LOCATION",
            "city": "Holly Springs",
            "state": "NC",
            "postal_code": "275408906",
            "country_code": "US",
            "telephone_number": "984-960-1800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETCHETTI",
        "first_name": "MANJULA",
        "middle_name": "RANI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-02",
        "last_updated": "2021-10-26",
        "certification_date": "2021-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME140645",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2008-00313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mpetchetti221486@direct.UNC.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "850 S Main St",
            "city": "Holly Springs",
            "state": "NC",
            "country_code": "US",
            "postal_code": "275408906",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Daisy Marsh Payne, RD, LDN
• Whitney Payne
• Angela H Pegram, PHARMD, CDE
• Kelly Pereira
• Shalyn Perez-Parris
• Billie Beard Peterson
• Krista Peterson, MA, LCMHCA
• Santina A Pfleeger, MA-LPA, HSP-PA
• Connie Smith Philbeck, L.P.A.
• Sean Pickler, PHARMD

• Pediatrics Physician in Albemarle, NC
• Providers in Albemarle, NC by specialty
• Pediatrics Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2021; 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.