Paul Lindsay Pettyjohn, OT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

15275 Issued in CA

Practice address

500 N Central Ave Ste 850
Glendale, CA 91203-3354

Phone

(818) 549-9764

Fax

(818) 549-9767

NPI assigned

Dec 5, 2006

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 1

Other names 1

• Paul Munro Other name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Texas Tech University Health Science Center School of Medicine, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Humboldt Hand and Foot TherapyGroup PAC ID 7911999792, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Humboldt Hand and Foot Therapy

  • Occupational Therapist
  • Eureka, CA
  • NPI 1891711271
  Medicare reassignment Care Compare group NPD
• Harold G Everett, M.D, PLLC

  • Specialist
  • Sequim, WA
  • NPI 1346420791
  NPD (past)
• Health Quest Therapy, Inc.

  • Occupational Therapy Assistant
  • Wasilla, AK
  • NPI 1982727640

  Occupational Therapist

  NPD (past)

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630281600000",
    "number": "1952469686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1845 BUSINESS CENTER DR STE 127",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083434",
            "telephone_number": "909-890-9030",
            "fax_number": "909-890-4393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N CENTRAL AVE STE 850",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912033354",
            "telephone_number": "818-549-9764",
            "fax_number": "818-549-9767"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 N Barranca St Ste 380",
            "address_purpose": "LOCATION",
            "city": "West Covina",
            "state": "CA",
            "postal_code": "917911637",
            "country_code": "US",
            "telephone_number": "626-331-8355",
            "fax_number": "909-890-4393",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETTYJOHN",
        "first_name": "PAUL",
        "middle_name": "LINDSAY",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2021-08-30",
        "certification_date": "2021-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "15275",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OCCUPATIONAL THERAPY",
            "identifier": "15275",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAUL",
            "last_name": "MUNRO",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Nelson Petrosyan, PT, DPT
• Nicole Monique Petrosyan, CF-SLP
• Ruzanna Petrosyan
• Sona Petrosyan
• Viktoriya Petrosyan, MSW
• Neda Petz
• Armen Joseph Pezeshkian, DDS
• Tracy Evalani Phal, PSY.D.
• Brianna Pham
• Thang Bao Pham, PA

• Occupational Therapist in Glendale, CA
• Providers in Glendale, CA by specialty
• Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.