Nicole Pettyjohn, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

LG-0011811 Issued in DE

Practice address

501 Silverside Rd Ste 102
Wilmington, DE 19809-1376

Phone

(443) 383-9300

Fax

(855) 866-8710

NPI assigned

Aug 27, 2015

Sex

Female

Sole proprietor

Yes

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 DE, MD2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cardiology Physicians, LLCGroup PAC ID 3476441841, 46 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Beebe Medical Center Hospital, Lewes, DE, CCN 080007
• Bayhealth Hospital, Sussex Campus Hospital, Milford, DE, CCN 080009

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: nicole.pettyjohn.p3@direct.chv.nextgenshare.com

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.

• Cardiology Physicians, LLC

  • Cardiovascular Disease Physician
  • Newark, DE
  • NPI 1952338212
  Medicare reassignment Care Compare group NPD
• Beebe Physician Network Inc.

  • Internal Medicine Physician
  • Lewes, DE
  • NPI 1730133992

  Family

  Medicare reassignment NPD
• Consonant Healing Associates of de LLC

  • Surgery Physician
  • Sparks, MD
  • NPI 1669099321

  DE

  Medicare reassignment NPD
• Consonant Healing Medical Associates

  • Surgery Physician
  • Silver Spring, MD
  • NPI 1588122535
  Medicare reassignment NPD
• Delmarva Mobile Wound Solutions LLC

  • Family Nurse Practitioner
  • Hebron, MD
  • NPI 1922894260
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Bayhealth Medical Center, Inc.

  • General Acute Care Hospital
  • Milford, DE
  • NPI 1023006434
  Care Compare affiliation
• Beebe Medical Center, Inc.

  • General Acute Care Hospital
  • Lewes, DE
  • NPI 1821196486
  Care Compare affiliation

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

{
    "created_epoch": "1440633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679011200000",
    "number": "1770950594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 RIDGEBROOK RD STE 300",
            "city": "SPARKS",
            "state": "MD",
            "postal_code": "211529477",
            "telephone_number": "443-383-9300",
            "fax_number": "855-866-8710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 SILVERSIDE RD STE 102",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198091376",
            "telephone_number": "443-383-9300",
            "fax_number": "855-866-8710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTYJOHN",
        "first_name": "NICOLE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-27",
        "last_updated": "2023-03-17",
        "certification_date": "2023-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "DE",
            "license": "L1-0047114",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "DE",
            "license": "LG-0011811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Petruccelli II, PT, DPT, SCS, OCS
• Douglas Pettiford
• Keith Pettiford
• Matthew Anthony Pettoruto
• Zachary Thomas Pettoruto, DMD
• Tanisha Pettyjohn
• Alexandra Erin Pevar, PT, DPT
• Jodie Beth Pezzner, ANP-C
• Tara A. Pezzuto, APN
• Cheri Pfeiffer, LCSW

• Family Nurse Practitioner in Wilmington, DE
• Providers in Wilmington, DE by specialty
• Family Nurse Practitioner in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2023; 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.
• 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.