NPIMap

Individual provider Active NPI

Lorie J. Petty, APRN.CNP

  • Acute Care Nurse Practitioner
  • Anchorage, AK
National Provider Identifier
1952835290
Registry record updated Feb 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
209330 Issued in AK
Practice address
3851 Piper St Ste U340
Anchorage, AK 99508-6904
Phone
(907) 562-0321
Fax
(907) 562-2683
NPI assigned
Apr 13, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 209330 AK
Gerontology Nurse Practitioner 363LG0600X 209330 AK
Acute Care Nurse Practitioner 363LA2100X 209330 AK Primary

Addresses

Primary practice location

3851 Piper St Ste U340
Anchorage, AK 99508-6904

Mailing address

3851 Piper St Ste U340
Anchorage, AK 99508-6904
Phone (907) 562-0321

Other practice location 1

12001 Business Blvd Ste 3C
Eagle River, AK 99577-7743
Phone (907) 562-0321

Other identifiers 1

IdentifierTypeStateIssuer
1742763MedicaidAK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
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
I20240327003476 AK Practitioner - Nurse Practitioner 8325319486 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Ohio State University College of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians
Katmai Oncology Group LLCGroup PAC ID 3072400498, 11 clinicians

Practice addresses (Care Compare)

10928 Eagle River Rd
Eagle River, AK 99577-8078
Phone (907) 694-8085

12001 Business Blvd
Suite 3C
Eagle River, AK 99577-7743
Phone (907) 562-0321

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Katmai Oncology Group, LLC CurrentSince Jan 28, 2024 Accepting new patients
Katmai Oncology Group, LLC CurrentSince Jan 28, 2024 Accepting new patients

Locations

3851 Piper St
Ste U340
Anchorage, AK 99508
Phone (907) 562-0321

12001 Business Blvd
Eagle River, AK 99577
Phone (907) 212-3420

12001 Business Blvd
Ste 3C
Eagle River, AK 99577
Phone (907) 562-0321

Organizations & group practices 2

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.

Hospital & facility affiliations 22

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

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1492041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738627200000",
    "number": "1952835290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3851 PIPER ST STE U340",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995086904",
            "telephone_number": "907-562-0321",
            "fax_number": "907-562-2683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3851 PIPER ST STE U340",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995086904",
            "telephone_number": "907-562-0321",
            "fax_number": "907-562-2683"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12001 Business Blvd Ste 3C",
            "address_purpose": "LOCATION",
            "city": "Eagle River",
            "state": "AK",
            "postal_code": "995777743",
            "country_code": "US",
            "telephone_number": "907-562-0321",
            "fax_number": "907-562-2683",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETTY",
        "first_name": "LORIE",
        "middle_name": "J.",
        "credential": "APRN.CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-13",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AK",
            "license": "209330",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "AK",
            "license": "209330",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AK",
            "license": "209330",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1742763",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.