Active NPI
Margaret Ann Pettus, SLP
- Speech-Language Pathologist
- Albuquerque, NM
National Provider Identifier
1891964938
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 705
- Practice address
- 6701 Fortuna Rd NW
West Mesa HS
Albuquerque, NM 87121-1306 - Phone
- (505) 831-6993
- NPI assigned
- Feb 22, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 705 | NM | Primary |
Addresses
Primary practice location
6701 Fortuna Rd NW
West Mesa HS
Albuquerque, NM 87121-1306
Mailing address
6701 Fortuna Rd NW
West Mesa HS
Albuquerque, NM 87121-1306
Phone (505) 831-6993
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| K 8272 | Medicaid | NM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 705 | NM | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1203638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1203638400000",
"number": "1891964938",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6701 FORTUNA RD NW",
"address_2": "WEST MESA HS",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871211306",
"telephone_number": "505-831-6993"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6701 FORTUNA RD NW",
"address_2": "WEST MESA HS",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871211306",
"telephone_number": "505-831-6993"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETTUS",
"first_name": "MARGARET",
"middle_name": "ANN",
"credential": "SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-02-22",
"last_updated": "2008-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NM",
"license": "705",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "K 8272",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.