Takana Petty

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

1227 Barberry LN
Peachtree City, GA 30269-6913

Phone

(678) 472-0394

NPI assigned

Apr 14, 2016

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1460592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460592000000",
    "number": "1851745939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1227 BARBERRY LN",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302696913",
            "telephone_number": "678-472-0394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1227 BARBERRY LN",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302696913",
            "telephone_number": "678-472-0394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTY",
        "first_name": "TAKANA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-14",
        "last_updated": "2016-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Rose Peronti, AGACNP-BC
• Dennis J. Perrott, D.D.S.
• Dimetrius Perrymond
• Kelly Rebecca Petaccio, MS LPC CPCS
• Melissa Kristine Petersen, NP
• Phalanx Med Georgia, LLC
• Pharmacy Place LLC (The Pharmacy Place)
• Pharmacy Place LLC
• Stacey Phillips
• Emson Philogene

• Community Health Worker in Peachtree City, GA
• Providers in Peachtree City, GA by specialty
• Community Health Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2016; 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.