INDIA PETTUS (NPI# 1306270533) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306270533 |
| Entity Type | Individual |
| Full Name | INDIA PETTUS |
| Credential | PA-C |
| Practice Address |
5530 Wisconsin Ave Suite 1660 Chevy Chase MD 20815-4404 |
| Mailing Address |
7250 Parkway Dr Ste 500 Hanover MD 21076-1343 |
| Practice Telephone | 3016579876 |
| Mailing Telephone | 4439490814 |
| Mailing Fax Number | 4439490825 |
| Enumeration Date | 2013-08-23 |
| Last Update Date | 2018-03-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | C0005125 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
C0005125 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
5530 WISCONSIN AVE SUITE 1660 |
| City | CHEVY CHASE |
| State | MD |
| Zip Code | 20815-4404 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427051424 | Madjid Matin | Dentist | 5530 Wisconsin Ave, Ste 1110, Chevy Chase, MD 20815-4330 | 2005-05-23 |
| 1508328378 | Bryn Marie Bonner | Physical Therapist | 5530 Wisconsin Ave, Chevy Chase, MD 20815-4404 | 2019-04-02 |
| 1578090791 | Eileen Patricia Goohs | Counselor | 5530 Wisconsin Ave, Chevy Chase, MD 20815-4404 | 2017-05-18 |
| 1427595107 | Anthony Alexander Gipe | Physical Therapist | 5530 Wisconsin Ave, Suite #1650, Chevy Chase, MD 20815-4404 | 2017-01-19 |
| 1528411253 | Scott D. Shapiro M.d., Ph.d., LLC | Internal Medicine | 5530 Wisconsin Ave, Suite 711, Chevy Chase, MD 20815-4404 | 2016-07-18 |
| 1669826517 | Cortney Elizabeth Tanner | Physician Assistant | 5530 Wisconsin Ave, Suite 1660, Chevy Chase, MD 20815-4404 | 2016-04-18 |
| 1386007565 | Elizabeth A Holcombe | Advanced Practice Midwife | 5530 Wisconsin Ave, Suite 1200, Chevy Chase, MD 20815-4404 | 2016-04-04 |
| 1083088355 | Miranda Stauffer | Physical Therapy Assistant | 5530 Wisconsin Ave, 1650, Chevy Chase, MD 20815-4404 | 2015-11-24 |
| 1063886042 | Emily Duke Wishik | Speech-Language Pathologist | 5530 Wisconsin Ave, Suite 1135, Chevy Chase, MD 20815-4404 | 2015-11-13 |
| 1285002469 | Mgmc, LLC | General Practice | 5530 Wisconsin Ave, Suite 960, Chevy Chase, MD 20815-4404 | 2015-09-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306456454 | Sarah Trandel-korenchuk | Nurse Practitioner | 4622 Norwood Drive, Chevy Chase, MD 20815 | 2020-08-04 |
| 1730709254 | Lorelyn Pierola | Physical Therapist | 8700 Jones Mill Road, Chevy Chase, MD 20815 | 2020-04-24 |
| 1194292391 | Bradley T Nguyen | Student in an Organized Health Care Education/Training Program | 5454 Wisconsic Ave, Bethesda, MD 20815 | 2018-10-26 |
| 1053897652 | Seth Parker Worthing | Orthopaedic Surgery | 5454 Wisconsin Ave Ste 1000, Chevy Chase, MD 20815 | 2018-07-17 |
| 1104310382 | Brendan F. Burke, M.d., L.L.C. | Obstetrics & Gynecology | 5530 Wisconsin Ave Ste 850, Chevy Chase, MD 20815 | 2018-06-20 |
| 1740778240 | Miriam Brazer | Student in an Organized Health Care Education/Training Program | 4810 Bradley Blvd, Chevy Chase, MD 20815 | 2018-04-30 |
| 1285131201 | Juventino Aceves | Speech-Language Pathologist | 5530 Wisconsin, Chevy Chase, MD 20815 | 2018-04-06 |
| 1386167351 | Seth A. Greenblatt | Social Worker | 2 Wisconsin Circle, Suite 700, Your Health Concierge, Inc, Bethesda, MD 20815 | 2017-07-21 |
| 1932636990 | Katelyn Marie Engbert | Registered Nurse | 4717 Morgan Dr, Chevy Chase, MD 20815 | 2017-05-20 |
| 1043752512 | Erin Leeland Nes | Marriage & Family Therapist | 4405 East West Highway Suite 408, Bethesda, MD 20815 | 2016-11-15 |
| Find all providers in zip 20815 | ||||
| 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 |
|---|---|---|---|---|
| 1326521295 | Hayley Bennett Coyle | Physician Assistant | 5454 Wisconsin Ave Ste 1045, Chevy Chase, MD 20815-6917 | 2018-09-07 |
| 1558502732 | Saleem Iqbal Sharar | Physician Assistant | 5425 Wisconsin Ave Ste 702, Chevy Chase, MD 20815 | 2009-03-17 |
| 1851952089 | Esteban Guillermo Mantilla Rodriguez | Physician Assistant | 8401 Connecticut Ave Ph Suite, Chevy Chase, MD 20815-5822 | 2019-06-27 |
| 1609358944 | Kerry Ann Martin | Physician Assistant | 5530 Wisconsin Ave Ste 914, Chevy Chase, MD 20815-4330 | 2018-09-04 |
| 1669826517 | Cortney Elizabeth Tanner | Physician Assistant | 5530 Wisconsin Ave, Suite 1660, Chevy Chase, MD 20815-4404 | 2016-04-18 |
| 1124437447 | Megan Baird | Physician Assistant | 8401 Connecticut Ave, Ste 800, Chevy Chase, MD 20815-5803 | 2014-08-12 |
| 1326475674 | Kara Johnson Danneberger | Physician Assistant | 5550 Friendship Blvd, Suite T-90, Chevy Chase, MD 20815-7256 | 2013-10-02 |
| 1386991453 | Suzanne Mehlhouse Adler | Physician Assistant | 5454 Wisconsin Ave, Suite 1400, Chevy Chase, MD 20815-6901 | 2012-08-08 |
| 1144556432 | Rachel A White | Physician Assistant | 5454 Wisconsin Ave, Suite 1045, Chevy Chase, MD 20815-6901 | 2009-10-22 |
| 1124223664 | Briana Marie Sweeney | Physician Assistant | 5454 Wisconsin Ave, Suite 1000, Chevy Chase, MD 20815-6901 | 2007-06-15 |
| Find all providers in CHEVY CHASE | ||||
| City | CHEVY CHASE |
| Zip Code | 20815 |
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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.