John B Pettway, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

J4434 Issued in TX

Practice address

121 E Randol Mill Rd
Arlington, TX 76011-5834

Phone

(817) 860-1309

NPI assigned

Mar 30, 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Family Practice

Education

University of Texas Medical School at San Antonio, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Catalyst Physician Group - NTX, PLLCGroup PAC ID 4284074758, 87 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Texas Health Arlington Memorial Hospital Hospital, Arlington, TX, CCN 450064

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: john.pettway.1@30724.direct.athenahealth.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.

• Catalyst Physician Group - NTX, PLLC

  • Family Medicine Physician
  • Plano, TX
  • NPI 1811677610
  Medicare reassignment Care Compare group NPD

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

• Texas Health Arlington Memorial Hospital

  • General Acute Care Hospital
  • Arlington, TX
  • NPI 1174533343
  Care Compare affiliation

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

{
    "created_epoch": "1143676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297814400000",
    "number": "1811958796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 E RANDOL MILL RD",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760115834",
            "telephone_number": "817-860-1309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 E RANDOL MILL RD",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760115834",
            "telephone_number": "817-860-1309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTWAY",
        "first_name": "JOHN",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-30",
        "last_updated": "2011-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "J4434",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04461401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Essence Peterson
• Jill Peterson, DDS, MPH, PHD
• Nikita Marie Peterson
• Alice D Petranek, OTR/L
• Nicholaus Petterson, D.C.
• Derek Andrew Petty, DDS
• Darrius Montre Peyton, COTA/L
• Reece Pfannenstiel, MD
• PH Ops of Arlington LLC
• Ailey Pham, PA-C

• Family Medicine Physician in Arlington, TX
• Providers in Arlington, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2011; 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.