CHELSEY PETTIS (NPI# 1346799871) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346799871 |
| Entity Type | Individual |
| Full Name | CHELSEY PETTIS |
| Practice Address |
100 Edwina St Evergreen AL 36401-3319 |
| Mailing Address |
101 Crestview Ave Evergreen AL 36401-3333 |
| Practice Telephone | 2515780278 |
| Practice Fax Number | 2515781055 |
| Mailing Telephone | 2515782480 |
| Mailing Fax Number | 2515781055 |
| Enumeration Date | 2016-09-26 |
| Last Update Date | 2016-09-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
1-098965 | AL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
100 EDWINA ST |
| City | EVERGREEN |
| State | AL |
| Zip Code | 36401-3319 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770559734 | Amrita Yearwood | Internal Medicine | 100 Edwina St, Evergreen, AL 36401-3319 | 2006-02-28 |
| 1346733821 | Franklin Primary Health Center, Inc | Internal Medicine | 100 Edwina St, Evergreen, AL 36401-3319 | 2018-06-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437347572 | Elizabeth L Godwin | Counselor | 101 Perryman Street Hwy 31, Compass Academy, Evergreen, AL 36401 | 2007-10-12 |
| 1679691661 | Floyd Michael Cartwright | Dentist | 122 Court Street, Evergreen, AL 36401 | 2007-03-27 |
| 1467526038 | Evergreen Dental Center | Dentist | 100 Edwina Street, Evergreen, AL 36401 | 2006-11-17 |
| 1134141229 | Michael L Pitts | Physical Therapist | 124 Edwina St, Evergreen, AL 36401 | 2006-07-24 |
| 1275565442 | Mark A Roberts | Family Medicine | 106 Edwina Street, Evergreen, AL 36401 | 2006-07-07 |
| 1881677581 | Evergreen Medical Center LLC | Registered Nurse | 308 South Main St, Evergreen, AL 36401 | 2005-11-28 |
| 1063918118 | Jessica Roberts Pierce | Nurse Practitioner | 106 Edwina Street, Evergreen, AL 36401 | 2018-04-05 |
| 1962535112 | Douglas Patrick O'connor | Dentist | 104 Hillcrest Dr, Evergreen, AL 36401 | 2007-03-14 |
| 1952466211 | Mark A Roberts Md PC | Family Medicine | 106 Edwina Street, Evergreen, AL 36401 | 2006-12-27 |
| 1659540086 | State of Alabama | Public Health or Welfare | Highway 83 and I-65, Evergreen, AL 36401-0565 | 2008-02-29 |
| Find all providers in zip 36401 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710441274 | Megan T Mcclintock | Nurse Practitioner | 30000 Sue Rd, Evergreen, CO 80439-7229 | 2019-01-29 |
| 1063918118 | Jessica Roberts Pierce | Nurse Practitioner | 106 Edwina Street, Evergreen, AL 36401 | 2018-04-05 |
| 1841715430 | Rickey Allen Blackburn Jr. | Nurse Practitioner | 102 Edwina St, Evergreen, AL 36401-3319 | 2017-08-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679174320 | Sweet Home Telehealth LLC | Nurse Practitioner | 3 Sudworth Dr Sw, Huntsville, AL 35824-4099 | 2020-11-07 |
| 1851991954 | Terry Brock | Nurse Practitioner | 4232 Cahaba Dr, Vestavia, AL 35243-1600 | 2020-10-28 |
| 1568062784 | Stephanie Terese Godwin | Nurse Practitioner | 391 Ashcraft Ln, Atmore, AL 36502-4225 | 2020-10-27 |
| 1588264725 | Sabine Susanne Lamont | Nurse Practitioner | 41 Eminence Way, Suite A, Pell City, AL 35128-2338 | 2020-10-27 |
| 1386243574 | Carl Andrew Ballard | Nurse Practitioner | 2635 Johnson Bottom Rd, Detroit, AL 35552-2731 | 2020-10-20 |
| 1023616661 | Yaira Maldonado | Nurse Practitioner | 191 Lee Road 207, Phenix City, AL 36870-8240 | 2020-10-15 |
| 1295333409 | Olivia Palmer | Nurse Practitioner | 770 W Market St, Athens, AL 35611 | 2020-10-12 |
| 1720685050 | Sean Jackson | Nurse Practitioner | 217 Tradewinds Cir, Alabaster, AL 35007-3019 | 2020-10-09 |
| 1104423235 | Rita Wiggins Branch | Nurse Practitioner | 12350 Flint Dr, Moundville, AL 35474-6246 | 2020-10-01 |
| 1538776778 | Mary Katherine Brandler | Nurse Practitioner | 1171 King Arthur Ct, Alabaster, AL 35007-3000 | 2020-09-30 |
| Find all providers with the same taxonomy | ||||
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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.