Karlton Shea Pettis, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

200301510 Issued in NC

Practice address

700 S Torrence St
Ste 100
Charlotte, NC 28204-3077

Phone

(704) 372-9393

Fax

(704) 372-0135

NPI assigned

Apr 3, 2006

Last updated

Feb 24, 2017By the provider in NPPES

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 2

Medicare fee-for-service enrollment

Enrolled in NC

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

Internal Medicine

Education

University of North Carolina at Chapel Hill School of Medicine, 1996

Medicare assignment

May accept Medicare assignment

Group practices

Amity Medical Group IncGroup PAC ID 7618205980, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Novant Health Presbyterian Medical Center Hospital, Charlotte, NC, CCN 340053
• Novant Health Huntersville Medical Center Hospital, Huntersville, NC, CCN 340183

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/22550/brand/1/csg/1/fhir/r4
• Direct secure messaging: karlton.pettis.1@12616.direct.athenahealth.com
• Direct secure messaging: karlton.pettis.1@22550.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Amity Medical Group, Inc.

  • Federally Qualified Health Center (FQHC)
  • Charlotte, NC
  • NPI 1003301300
  Medicare reassignment Care Compare group NPD
• Metrolina Internal Medicine PA

  • Internal Medicine Physician
  • Charlotte, NC
  • NPI 1326000845
  Medicare reassignment NPD

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

• The Presbyterian Hospital

  dba Novant Health Huntersville Medical Center

  • General Acute Care Hospital
  • Huntersville, NC
  • NPI 1346291309
  Care Compare affiliation
• The Presbyterian Hospital

  dba Presbyterian ESRD Unit

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Charlotte, NC
  • NPI 1396798591

  Hospital

  Care Compare affiliation
• The Presbyterian Hospital

  dba Presbyterian Behavioral Health Unit

  • Psychiatric Hospital Unit
  • Charlotte, NC
  • NPI 1497708838
  Care Compare affiliation
• The Presbyterian Hospital

  dba Novant Health Presbyterian Medical Center

  • General Acute Care Hospital
  • Charlotte, NC
  • NPI 1881647204
  Care Compare affiliation
• The Presbyterian Hospital

  dba Novant Health Presbyterian Medical Center - Skilled Nursing Unit

  • Skilled Nursing Facility
  • Charlotte, NC
  • NPI 1891871901

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487894400000",
    "number": "1871555375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 S TORRENCE ST",
            "address_2": "STE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282043077",
            "telephone_number": "704-372-9393",
            "fax_number": "704-372-0135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 S TORRENCE ST",
            "address_2": "STE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282043077",
            "telephone_number": "704-372-9393",
            "fax_number": "704-372-0135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTIS",
        "first_name": "KARLTON",
        "middle_name": "SHEA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-03",
        "last_updated": "2017-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "200301510",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE LEGACY NUMBER",
            "identifier": "2025155",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89136C1",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eric Pettice
• Synovia Pettice, LCAS
• Amy Dietzen Petticrew, PA-C
• Jarret Pettigrew
• Nicole Marie Pettine, AU.D.
• Pamela Cobb Pettis, MD
• Angela Pettit, CSAC
• Crystal Shannon Pettit, MAED
• Tynnatta Maria Pettit, LCSW-A
• Zachary David Pettit, PA-C

• Internal Medicine Physician in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Internal Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2017; 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.