MS. MARY E. PETTIT (NPI# 1083643548) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083643548 |
| Entity Type | Individual |
| Full Name | MS. MARY E. PETTIT |
| Credential | P.A.-C. |
| Practice Address |
1301 2nd Ave Sw Largo FL 33770-3120 |
| Mailing Address |
Po Box 64664 Baltimore MD 21264-4664 |
| Practice Telephone | 7275818767 |
| Practice Fax Number | 7275812739 |
| Mailing Telephone | 4105500453 |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2015-10-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | C04291 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1301 2ND AVE SW |
| City | LARGO |
| State | FL |
| Zip Code | 33770-3120 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407851314 | Diagnostic Clinic Medical Group Inc. | Allergy & Immunology | 1301 2nd Ave Sw, Largo, FL 33770-3120 | 2005-06-16 |
| 1952924979 | Jordan Ashley Bennett | Advanced Practice Midwife | 1301 2nd Ave Sw, Largo, FL 33770-3120 | 2020-05-26 |
| 1205477072 | Calli Keenan Fodor | Audiologist | 1301 2nd Ave Sw, Largo, FL 33770-3120 | 2019-10-03 |
| 1093283145 | Patricia Hanratty | Nurse Practitioner | 1301 2nd Ave Sw, Largo, FL 33770-2298 | 2018-11-07 |
| 1649786781 | Erica Anne Martin | Physician Assistant | 1301 2nd Ave Sw, Largo, FL 33770-2298 | 2017-12-27 |
| 1144736927 | Mladen Nikolic | Nurse Practitioner | 1301 2nd Ave Sw, Largo, FL 33770 | 2017-12-15 |
| 1922524958 | Kimmy Nhut Nguyen | Physician Assistant | 1301 2nd Ave Sw, Largo, FL 33770 | 2017-08-22 |
| 1164959920 | Orthopaedic Associates of West Florida, Pa | Clinic/Center | 1301 2nd Ave Sw, Fl 6, Largo, FL 33770-3120 | 2017-05-11 |
| 1932644580 | Janet A Mccormick | Nurse Practitioner | 1301 2nd Ave Sw, Largo, FL 33770-2298 | 2017-01-05 |
| 1619323417 | Optic Shoppe Dme | Durable Medical Equipment & Medical Supplies | 1301 2nd Ave Sw, Largo, FL 33770-3120 | 2016-05-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467005041 | Chelsey Lyn Shepos | Optometrist | 1030 West Bay Dr, Suite 200, Largo, FL 33770 | 2019-07-22 |
| 1407353626 | Michael E Ibrahim | Pharmacist | 1290 West Bay Drive, Largo, FL 33770 | 2018-04-13 |
| 1518413384 | Payton Kuhlenbeck | Anesthesiology | 210 14th Street Sw, Largo, FL 33770 | 2016-08-31 |
| 1639536865 | Ryan Boice | Physical Therapy Assistant | 118 West Bay Drive, Suite 111, Largo, FL 33770 | 2016-01-19 |
| 1508238858 | Alignment Healthcare Florida LLC | Clinic/Center | 1301 2nd Ave., Sw, Largo, FL 33770 | 2015-10-27 |
| 1891161808 | Jessica Nicole Mcglone | Nurse Practitioner | 601 Rosery Rd Ne Apt 1502, Largo, FL 33770 | 2015-08-12 |
| 1033598602 | Demetria Anderson | Counselor | 1301 Seminole Blvd Ste 103, Largo, FL 33770 | 2015-05-28 |
| 1962881821 | Building Blocks Therapy, Pllc | Community/Behavioral Health | 1301 Seminole Blvd Building A Suite 103, Largo, FL 33770 | 2015-05-26 |
| 1457765968 | Summer Moon | Dermatology | 115 Highland Ave N, Largo, FL 33770 | 2014-06-12 |
| 1578982393 | Lauren Elizabeth Grandpre | Emergency Medicine | 201 14th St. Sw, Largo Medical Center Emergency Department, Largo, FL 33770 | 2014-04-09 |
| Find all providers in zip 33770 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235736794 | Delaney Herper | Physician Assistant | 11049 116th St, Largo, FL 33778-3731 | 2020-10-07 |
| 1376179267 | Latoya Maritza Navarrete | Physician Assistant | 1945 E Bay Dr Apt B, Largo, FL 33771-2217 | 2020-03-23 |
| 1740821677 | Hannah Robinson | Physician Assistant | 12170 119th St, Largo, FL 33778-2000 | 2019-10-02 |
| 1568935971 | Natalie Restrepo | Physician Assistant | 8250 Bryan Dairy Rd Ste 305, Largo, FL 33777-1360 | 2019-01-08 |
| 1821533126 | Darlene Edmunds | Physician Assistant | 8787 Bryan Dairy Rd Ste 310, Largo, FL 33777-1255 | 2016-12-22 |
| 1154573210 | Sarah D Martin | Physician Assistant | 8250 Bryan Dairy Road, Largo, FL 33777-1353 | 2008-10-21 |
| 1205051125 | Jessica Mcgargle Heinberg | Physician Assistant | 1301 2nd Ave Sw Ste 315, Largo, FL 33770 | 2007-04-16 |
| 1770686040 | Paul Badiali | Physician Assistant | 12309 91st Way North, Largo, FL 33773 | 2006-09-05 |
| 1316040694 | Mark V Ward | Physician Assistant | 16370 Walsingham Road, Largo, FL 33774-3532 | 2006-09-05 |
| 1750399226 | Leslie A Pasto Manetta | Physician Assistant | 13670 Walsingham Road, Largo, FL 33774 | 2006-08-03 |
| Find all providers in LARGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.