Elvy Pettit Jr., P.A.

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

101961 Issued in NC

Practice address

3080 Trenwest Dr
The Salem Center
Winston Salem, NC 27103-3208

Phone

(336) 768-0496

Fax

(336) 768-0498

NPI assigned

Mar 25, 2008

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

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Jaime E Trujillo MD PA

  • Internal Medicine Physician
  • Winston Salem, NC
  • NPI 1730301037
  Medicare reassignment

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

{
    "created_epoch": "1206403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206403200000",
    "number": "1972775427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3080 TRENWEST DR",
            "address_2": "THE SALEM CENTER",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033208",
            "telephone_number": "336-768-0496",
            "fax_number": "336-768-0498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3080 TRENWEST DR",
            "address_2": "THE SALEM CENTER",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033208",
            "telephone_number": "336-768-0496",
            "fax_number": "336-768-0498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTIT",
        "first_name": "ELVY",
        "name_suffix": "Jr.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-25",
        "last_updated": "2008-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "101961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Milan Petrovic
• Patricia Harper Petrozza, MD
• Portia Pettigrew
• Seqouia Jabre Pettigrew
• Heather L Pettit-Mee, M.A., CFY-SLP/L
• Danielle Robinson Petty, D.O.
• John K Petty, MD
• William Jeffrey Petty Jr.
• William McCandless Petty, MD
• Christine Marie Peverini, DNP, ARNP, ANP-BC

• Medical Physician Assistant in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Medical Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2008; 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.