Donald Pettey

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

24097 Issued in OK

Practice address

1222 10TH St Ste 211
Woodward, OK 73801-3156

Phone

(580) 256-8615

Fax

(580) 256-8643

NPI assigned

May 21, 2007

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982813788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1222 10TH ST STE 211",
            "city": "WOODWARD",
            "state": "OK",
            "postal_code": "738013156",
            "telephone_number": "580-256-8615",
            "fax_number": "580-256-8643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1222 10TH ST STE 211",
            "city": "WOODWARD",
            "state": "OK",
            "postal_code": "738013156",
            "telephone_number": "580-256-8615",
            "fax_number": "580-256-8643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTEY",
        "first_name": "DONALD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OK",
            "license": "24097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Paul Peck, O.D.
• Mario A Perez
• Clifford Alden Perkins
• Haley C Persons
• Patricia Peters
• Phillip W Powell DDS
• Barbie Dawn Phillips, DC
• Physical Therapy Health & Sports Care, Inc.
• Kimberly Sue Pier, NP
• Krystan Noel Pierce

• Licensed Practical Nurse in Woodward, OK
• Providers in Woodward, OK by specialty
• Licensed Practical Nurse in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.