Bryan Keith Pettit, R.N., CCM

Primary specialty

Rehabilitation PractitionerTaxonomy code 225400000X

Practice address

5555 Glendon CT
Dublin, OH 43016-3249

Phone

(877) 641-2010

NPI assigned

Oct 3, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

Practice roles

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.

• Vocworks

  • Exclusive Provider Organization
  • Dublin, OH
  • NPI 1538432331
  NPD (past)

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

{
    "created_epoch": "1191369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191369600000",
    "number": "1841487972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 474",
            "city": "JACKSON",
            "state": "OH",
            "postal_code": "456400474",
            "telephone_number": "740-286-8646",
            "fax_number": "740-286-4676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 GLENDON CT",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430163249",
            "telephone_number": "877-641-2010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTIT",
        "first_name": "BRYAN",
        "middle_name": "KEITH",
        "credential": "R.N., CCM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-03",
        "last_updated": "2007-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CCM",
            "identifier": "00049080",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OH BOARD OF NURSING",
            "identifier": "RN262281",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Josephine Petro
• Kari Petry
• Kyle Pettay, DO
• Kelly Pettis
• Robyn Pettis
• Robert Pfeifer, RPH
• William Pfeifer
• Sheryl Ann Pfeil, MD
• Xuan Thanh Thi Pham, O.D.
• Riley Pharion

• Rehabilitation Practitioner in Dublin, OH
• Providers in Dublin, OH by specialty
• Rehabilitation Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2007; 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.