Taryn Petty, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209014893 Issued in IL

Practice address

31 Sibley St
Hammond, IN 46320

Phone

(219) 802-8800

Fax

(219) 802-8801

NPI assigned

Sep 23, 2016

Last updated

Oct 18, 2019By the provider in NPPES

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)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1474588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571356800000",
    "number": "1881143469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 SIBLEY ST",
            "city": "HAMMOND",
            "state": "IN",
            "postal_code": "463201725",
            "telephone_number": "219-802-8800",
            "fax_number": "219-802-8801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 SIBLEY ST",
            "city": "HAMMOND",
            "state": "IN",
            "postal_code": "46320",
            "telephone_number": "219-802-8800",
            "fax_number": "219-802-8801"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "434 Sandpiper Dr",
            "address_purpose": "LOCATION",
            "city": "Schererville",
            "state": "IN",
            "postal_code": "463752989",
            "country_code": "US",
            "telephone_number": "708-212-0029",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETTY",
        "first_name": "TARYN",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-23",
        "last_updated": "2019-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209014893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Path to Purpose Living LLC
• Patrick Pontee M.D.
• John F Perez, MD
• Jovan Perkins, RPH, PHARMD
• Debra Antoinette Petersen, NURSE PRACTITIONER
• Pharma-Card West, Inc
• Shekila Nicole Phillips
• Joseph Piekarczyk Jr., DDS
• Melissa Carol Pietraszak
• Eve Pinkey

• Family Nurse Practitioner in Hammond, IN
• Providers in Hammond, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2019; 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.