MR. GARY COURTLAND PETTIT (NPI# 1114366614) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114366614 |
| Entity Type | Individual |
| Full Name | MR. GARY COURTLAND PETTIT |
| Credential | BA |
| Practice Address |
1616 Frances Ave Fort Pierce FL 34949-3559 |
| Practice Telephone | 7725199197 |
| Mailing Telephone | 7725199197 |
| Enumeration Date | 2013-06-18 |
| Last Update Date | 2013-06-18 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| Street Address |
1616 FRANCES AVE |
| City | FORT PIERCE |
| State | FL |
| Zip Code | 34949-3559 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528459666 | Lazaro R Completo Jr. | Internal Medicine | #c-823 2400 South Ocean Drive, Fort Pierce, FL 34949 | 2015-02-11 |
| 1518181833 | Drew Leland Peterson | Chiropractor | 1010 South Us#1, Fort Pierce, FL 34949 | 2007-04-11 |
| 1225524259 | Infectious Disease Consultants, LLC | Skilled Nursing Facility | 13 Harbour Isle Dr W Ph 2, Fort Pierce, FL 34949-2765 | 2018-07-02 |
| 1568804862 | Lisa Renee Cason | Nurse Practitioner | 13 Harbour Isle Dr W, West Ph2, Fort Pierce, FL 34949-2765 | 2013-07-27 |
| 1508200197 | Hazem Eluri | Pharmacist | 16 Harbour Isle Dr W Unit 304, Fort Pierce, FL 34949-2768 | 2013-04-25 |
| 1922114289 | Arthur Pierre-louis | Psychiatry & Neurology | 22 Harbour Isle Dr W, Apt 306, Fort Pierce, FL 34949-2774 | 2006-08-21 |
| 1467875195 | Viany E Adache | Developmental Therapist | 29 Harbour Isle Dr W Unit 206, Fort Pierce, FL 34949-2781 | 2014-01-31 |
| 1942823786 | Jessica Rigal | Social Worker | 30 Harbour Isle Dr W Unit 202, Hutchinson Island, FL 34949-2782 | 2020-05-27 |
| 1023026218 | Frank Pierrepont Whitridge Jr. | Massage Therapist | 1232 Bonefish Ct, Fort Pierce, FL 34949-2901 | 2006-08-03 |
| 1104990621 | Ocean Side Pharmacy | Pharmacy | 1118 Colonnades Dr, Ft Pierce, FL 34949-3063 | 2006-11-17 |
| Find all providers in zip 34949 | ||||
| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528531472 | Rakevah Wilson | Case Manager/Care Coordinator | 7005 Paso Robles Blvd, Fort Pierce, FL 34951-1223 | 2019-01-03 |
| 1972019255 | Starvelle Hickman | Case Manager/Care Coordinator | 222 Grand Club Pl, Fort Pierce, FL 34982-8124 | 2017-12-21 |
| 1548614076 | Guardian Insurance Group | Case Manager/Care Coordinator | 1101 N Us Highway 1, Fort Pierce, FL 34950-9128 | 2016-04-21 |
| 1053777953 | Mary K. Wright | Case Manager/Care Coordinator | 2698 Conifer Dr, Fort Pierce, FL 34951-2940 | 2016-01-07 |
| 1588035596 | Mary Larry | Case Manager/Care Coordinator | 1807 Fulton Dr, Fort Pierce, FL 34950-3939 | 2015-10-16 |
| 1952792764 | Casper Lockwood | Case Manager/Care Coordinator | 2814 South U.s Hwsy 1, Suite D4, Fort Pierce, FL 34982 | 2015-02-16 |
| 1215276845 | Rashandia Johnson | Case Manager/Care Coordinator | 2707 Walker Dr, Fort Pierce, FL 34946-1170 | 2013-02-01 |
| 1720688229 | Aquanda Thomas | Case Manager/Care Coordinator | 2011 S 25th St Ste 108, Fort Pierce, FL 34947-4795 | 2020-10-26 |
| 1972147171 | Tyisha Kenshawna St. Surin | Case Manager/Care Coordinator | 2011 S 25th St Ste 108, Fort Pierce, FL 34947-4795 | 2019-10-30 |
| 1407499668 | Janette E Oliver Roberts | Case Manager/Care Coordinator | 2011 S 25th St Ste 108, Fort Pierce, FL 34947-4795 | 2019-10-21 |
| Find all providers in FORT PIERCE | ||||
| City | FORT PIERCE |
| Zip Code | 34949 |
Please comment or provide details below to improve the information on MR. GARY COURTLAND PETTIT.
| 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.