NPIMap

Individual provider Active NPI

Ryan C Pettit, MD

  • Family Medicine Physician
  • Cullman, AL
National Provider Identifier
1902048226
Registry record updated Jan 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD.31240 Issued in AL
Practice address
1958 Al Highway 157
Cullman, AL 35058-0609
Phone
(256) 737-2090
Fax
(256) 737-2091
NPI assigned
Apr 1, 2009
Last updated
Jan 5, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD.31240 AL Primary
Family Medicine Physician 207Q00000X 31240 AL

Addresses

Primary practice location

1958 Al Highway 157
Cullman, AL 35058-0609

Mailing address

PO Box 2895
Cullman, AL 35056-2895
Phone (256) 735-5071

Other practice location 1

1549 Highway 31 NW
Hartselle, AL 35640-4431
Phone (256) 735-5920

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120104000806 AL Practitioner - Family PracticePractitioner - Emergency Medicine 4486820966 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of South Alabama College of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Small Hospital Innovations LLCGroup PAC ID 0840415444, 95 clinicians

Practice addresses (Care Compare)

301 E 18TH St
Anniston, AL 36207-3952
Phone (256) 235-8900

600 S 3Rd St
Gadsden, AL 35901-5304
Phone (256) 543-5200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
31240ALMDFamily Medicine Physician
MD.31240ALMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alabama Emergency Physician Partners, LLC CurrentSince Aug 1, 2025 Accepting new patients
Alteon Health Alabama, LLC CurrentSince Sep 1, 2025 Accepting new patients
Marshall Medical Center North CurrentSince May 9, 2014 Accepting new patients
Marshall Medical Center South CurrentSince May 18, 2024 Accepting new patients
Alabama Emergency Physician Partners, LLC Current Accepting new patients
Marshall Family Medicine Family Medicine PastSince Mar 24, 2025 Accepting new patients

Locations

301 E 18th St
Anniston, AL 36207
Phone (256) 235-8900

2505 US Highway 431
Boaz, AL 35957
Phone (256) 506-0061

1007 Goodyear Ave
Gadsden, AL 35903
Phone (256) 494-4000

600 S 3rd St
Gadsden, AL 35901
Phone (256) 543-5200

8000 AL Highway 69
Guntersville, AL 35976
Phone (256) 571-8000

604 Stone Ave
Talladega, AL 35160
Phone (256) 362-8111

Organizations & group practices 7

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1238544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641340800000",
    "number": "1902048226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2895",
            "city": "CULLMAN",
            "state": "AL",
            "postal_code": "350562895",
            "telephone_number": "256-735-5071",
            "fax_number": "256-801-7626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1958 AL HIGHWAY 157",
            "city": "CULLMAN",
            "state": "AL",
            "postal_code": "350580609",
            "telephone_number": "256-737-2090",
            "fax_number": "256-737-2091"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1549 Highway 31 NW",
            "address_purpose": "LOCATION",
            "city": "Hartselle",
            "state": "AL",
            "postal_code": "356404431",
            "country_code": "US",
            "telephone_number": "256-735-5920",
            "fax_number": "256-678-7710",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETTIT",
        "first_name": "RYAN",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-01",
        "last_updated": "2022-01-05",
        "certification_date": "2022-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "MD.31240",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "31240",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cullman, AL

Sources for this page

Verify at the official NPI Registry.