Galen Wayne Pettey, PHYSICAL THERAPIST

Primary specialty

SpecialistTaxonomy code 174400000X

License

PT 22807 Issued in CA

Practice address

2600 Newburg Rd
Fortuna, CA 95540-2536

Phone

(707) 725-6995

Fax

(707) 725-9152

NPI assigned

Jul 4, 2006

Sex

Male

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

Enrolled in CA

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

88.88 of 100Reported as group

Quality

80

Improvement activities

40

Cost

89.61

Medicare enrollment (NPD)

Enrolled

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.

• Eureka Physical Therapy

  • Specialist
  • Eureka, CA
  • NPI 1861422818
  Medicare reassignment NPD

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366934400000",
    "number": "1770513657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2306 DEAN ST",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955013209",
            "telephone_number": "707-443-8354",
            "fax_number": "707-443-8628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 NEWBURG RD",
            "city": "FORTUNA",
            "state": "CA",
            "postal_code": "955402536",
            "telephone_number": "707-725-6995",
            "fax_number": "707-725-9152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTEY",
        "first_name": "GALEN",
        "middle_name": "WAYNE",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2013-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "PT 22807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Open Door Community Health Centers
• Joseph A Ortola, DDS
• Pacific Memorial Anesthesia Care, Inc
• Paul Stauffer, P.C.
• Kristin Leigh Perkins, LCSW
• Philip L. Olkin, M.D. and C. Ray Jones, M.D.
• Felice Philips
• Lacey Pipher
• Anthony Pirouz, PA-C
• Red Phoenix Recovery LLC

• Specialist in Fortuna, CA
• Providers in Fortuna, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.