JOHN PETTIT (NPI# 1396823829) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396823829 |
| Entity Type | Individual |
| Full Name | JOHN PETTIT |
| Credential | M.D. |
| Practice Address |
1209 W Target Range Rd Suite 4 Nogales AZ 85621-2465 |
| Mailing Address |
2202 N Forbes Blvd Tucson AZ 85745-1412 |
| Practice Telephone | 5202853000 |
| Mailing Telephone | 5208727700 |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2013-04-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | 20942 | AZ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | PIN | H30040G | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164732715 | John Derrick Pettit | Contractor | 6800 Nw 39th Ave. Lot 486, Coconut Creek, FL 33073 | 2010-10-18 |
| 1407937253 | John Mark Pettit | Urology | 340 Birchwood Ave, Bellingham, WA 98225-1782 | 2006-10-18 |
| 1487713335 | John Algren Pettit | Optometrist | 1480 Us Highway 17 N, Inside Walmart Vision, Wauchula, FL 33873-5006 | 2006-12-07 |
| Street Address |
1209 W TARGET RANGE RD SUITE 4 |
| City | NOGALES |
| State | AZ |
| Zip Code | 85621-2465 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447242300 | Oscar I Rojas | Pediatrics | 1209 W Target Range Rd, Suite 103, Nogales, AZ 85621-2466 | 2005-08-17 |
| 1013523539 | Mariposa Community Health Center | Family Medicine | 1209 W Target Range Rd, Nogales, AZ 85621-2466 | 2020-09-21 |
| 1922418979 | Jared Ryan Lunkenheimer | Family Medicine | 1209 W Target Range Rd, Nogales, AZ 85621-2466 | 2014-04-29 |
| 1225479868 | Lydia H. Rivera | Nurse Practitioner | 1209 W Target Range Rd, Nogales, AZ 85621-2466 | 2013-07-11 |
| 1457604506 | Martha Veronica Borbon | Nurse Practitioner | 1209 W Target Range Rd, Nogales, AZ 85621-2466 | 2012-10-25 |
| 1023387958 | Valley Ent, PC | Otolaryngology | 1209 W Target Range Rd, Nogales, AZ 85621-2466 | 2011-12-21 |
| 1306864145 | Leo Gaston Stinnett Jr. | Surgery | 1209 W Target Range Rd, Nogales, AZ 85621-2466 | 2006-07-18 |
| 1811930423 | Jeffrey Thomas Maudlin | Family Medicine | 1209 W Target Range Rd, Nogales, AZ 85621-2466 | 2006-06-13 |
| 1861469389 | Miriam E Downey | Nurse Practitioner | 1209 W Target Range Rd, Nogales, AZ 85621-2466 | 2006-03-02 |
| 1679552749 | Maria Gwen Gallegos | Nurse Practitioner | 1209 W Target Range Rd, Nogales, AZ 85621-2466 | 2006-01-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548771033 | Intermountain Health Center, Inc. | Community/Behavioral Health | 272 West Viewpoint Drive, Nogales, AZ 85621 | 2017-10-24 |
| 1336696657 | Intermountain Centers for Human Development Inc. | Community/Behavioral Health | 276 West View Point Drive, Nogales, AZ 85621 | 2016-09-02 |
| 1831584291 | Helping Ourselves Pursue Enrichment, Inc. | Community/Behavioral Health | 1857 N Mastick Way, Nogales, AZ 85621 | 2015-04-02 |
| 1043504376 | Community Intervention Associates | Community/Behavioral Health | 32 Blvd Del Rey David, Nogales, AZ 85621 | 2011-06-03 |
| 1568782175 | Arizona's Children Association | Clinic/Center | 1740 N. Mastick Way, Suite D, Nogales, AZ 85621 | 2010-06-04 |
| 1811032493 | Susan M. Jaworski | Local Education Agency (LEA) | 315 Plum Street, Nogales, AZ 85621 | 2007-02-21 |
| 1194885905 | Alex Gracia | Pharmacy Technician | 839 W. Calle Chico, Nogales, AZ 85621 | 2006-12-11 |
| 1982716130 | Yvette Denise Braun | Chiropractor | 1821 N Mastick Way #1, Nogales, AZ 85621 | 2006-08-31 |
| 1043254154 | John Diaz | Emergency Medicine | 1171 W Target Range Road, Carondelet Holy Cross Hospital, Nogales, AZ 85621 | 2006-06-16 |
| 1467495085 | Bart L Mc Rae | Emergency Medicine | Carondelet Holy Cross Hospital, 1171 W. Target Range Road, Nogales, AZ 85621 | 2006-06-13 |
| Find all providers in zip 85621 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306864145 | Leo Gaston Stinnett Jr. | Surgery | 1209 W Target Range Rd, Nogales, AZ 85621-2466 | 2006-07-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598365702 | Ducharme General Surgery, Pllc | Surgery | 1200 N El Dorado Pl Ste E-520, Tucson, AZ 85715-4637 | 2020-10-27 |
| 1407465081 | Arizona Advanced Surgical and Pain | Surgery | 5235 E Southern Ave Ste D106-444, Mesa, AZ 85206-3626 | 2020-07-29 |
| 1588285910 | Casey Leonard Charlton | Surgery | 1300 E Fort Lowell Rd, Tucson, AZ 85719-2222 | 2020-04-27 |
| 1235760406 | Star Surgery Center, LLC | Surgery | 14155 N 83rd Ave Ste 140, Peoria, AZ 85381-5652 | 2020-01-28 |
| 1841842747 | Scottsdale Outpatient Surgery | Surgery | 8994 E Desert Cove Ave Ste 101, Scottsdale, AZ 85260-7901 | 2019-07-10 |
| 1730744228 | Zona Surgery Center, LLC | Surgery | 8994 E Desert Cove Ave Ste 100, Scottsdale, AZ 85260-7901 | 2019-05-09 |
| 1033684741 | Michael Joseph Pllc | Surgery | 29455 N Cave Creek Rd Ste 118-451, Cave Creek, AZ 85331-3245 | 2018-10-09 |
| 1215411970 | Center for Vein Restoration Az LLC | Surgery | 1500 S Dobson Rd Ste 310, Mesa, AZ 85202-4751 | 2018-09-19 |
| 1043701543 | Lakeshore Interventional Treatment Center LLC | Surgery | 4765 S Lakeshore Dr, Tempe, AZ 85282 | 2018-05-21 |
| 1831686112 | Facasurgery LLC | Surgery | 1831 E Queen Creek Rd # 120, Chandler, AZ 85286-2019 | 2018-04-22 |
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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.