Precious A Pettaway

Primary specialty

Rehabilitation PractitionerTaxonomy code 225400000X

Practice address

3624 Russian Olive St
North Las Vegas, NV 89032-7643

Phone

(702) 353-1079

NPI assigned

Aug 21, 2012

Sex

Female

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

Practice roles

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.

• Steppin Out Family Services LLC.,

  • Community/Behavioral Health Agency
  • North Las Vegas, NV
  • NPI 1306156682
  NPD (past)
• 7Steps BHS

  • Community/Behavioral Health Agency
  • Mesa, AZ
  • NPI 1174228787
  NPD (past)

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

{
    "created_epoch": "1345507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345507200000",
    "number": "1992053037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3624 RUSSIAN OLIVE ST",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890327643",
            "telephone_number": "702-353-1079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3624 RUSSIAN OLIVE ST",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890327643",
            "telephone_number": "702-353-1079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTAWAY",
        "first_name": "PRECIOUS",
        "middle_name": "A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-21",
        "last_updated": "2012-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandra Peterson
• Cheryle Nichole Peterson, APRN
• Dejuan Peterson
• Mercy Peterson
• Carmen Graciela Petrin
• Sherry Pettaway
• Pfau Atlas Psychiatry PLLC
• Ann Pham, D.D.S.
• Selena N Pham, PHARMD
• Tuong Le Cat Pham

• Rehabilitation Practitioner in North Las Vegas, NV
• Providers in North Las Vegas, NV by specialty
• Rehabilitation Practitioner in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2012; 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.