Individual provider Active NPI

Anthony Michael Pettinato, PHARMD

  • Pharmacist
  • Nicholasville, KY
National Provider Identifier
1770975286
Registry record updated Dec 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
017349 Issued in KY
Practice address
1401 Keene Rd
Nicholasville, KY 40356-8922
Phone
(859) 881-3682
NPI assigned
Feb 21, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 017349 KY Primary

Addresses

Primary practice location

1401 Keene Rd
Nicholasville, KY 40356-8922

Mailing address

1401 Keene Rd
Nicholasville, KY 40356-8922
Phone (859) 881-3682

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
017349KYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1424476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671753600000",
    "number": "1770975286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 KEENE RD",
            "city": "NICHOLASVILLE",
            "state": "KY",
            "postal_code": "403568922",
            "telephone_number": "859-881-3682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 KEENE RD",
            "city": "NICHOLASVILLE",
            "state": "KY",
            "postal_code": "403568922",
            "telephone_number": "859-881-3682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTINATO",
        "first_name": "ANTHONY",
        "middle_name": "MICHAEL",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-21",
        "last_updated": "2022-12-23",
        "certification_date": "2022-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KY",
            "license": "017349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nicholasville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2022; 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.