Thomas Christopher Pettinger, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

1515 Issued in AZ

Practice address

14413 East Sands Ranch Road
Vail, AZ 85641-8876

Phone

(520) 661-6089

Fax

(520) 561-8493

NPI assigned

Oct 12, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Benson Hospital Corporation

  • Critical Access Hospital
  • Benson, AZ
  • NPI 1336118322
  Medicare reassignment NPD
• Benson Hospital Corporation

  • Rural Health Clinic/Center
  • Vail, AZ
  • NPI 1457924920
  NPD

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624233600000",
    "number": "1891884433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14413 EAST SANDS RANCH ROAD",
            "city": "VAIL",
            "state": "AZ",
            "postal_code": "856418876",
            "telephone_number": "520-661-6089",
            "fax_number": "520-561-8493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14413 EAST SANDS RANCH ROAD",
            "city": "VAIL",
            "state": "AZ",
            "postal_code": "856418876",
            "telephone_number": "520-661-6089",
            "fax_number": "520-561-8493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTINGER",
        "first_name": "THOMAS",
        "middle_name": "CHRISTOPHER",
        "name_prefix": "Mr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2021-06-21",
        "certification_date": "2021-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A4257",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "1515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kishna Marie Outlaw
• Amber Palmer
• Joseph Russell Patterson, PHD
• Stacie Periclos, P.T.
• Courtney Perrier Bear, FDN-P
• Brian Pondel
• Amber Poplewko-Armstrong, LMSW
• Chemahya Ereen Prince
• Linda Rachelle
• Ramon Bartolo Ramirez Rojas

• Family Medicine Physician in Vail, AZ
• Providers in Vail, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.