DR. JOHN MARK PETTIT (NPI# 1407937253) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407937253 |
| Entity Type | Individual |
| Full Name | DR. JOHN MARK PETTIT |
| Credential | MD |
| Practice Address |
340 Birchwood Ave Bellingham WA 98225-1782 |
| Practice Telephone | 3606719197 |
| Practice Fax Number | 3606767730 |
| Mailing Telephone | 3606719197 |
| Mailing Fax Number | 3606767730 |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2012-12-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | MD00024911 | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 1032978 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164732715 | John Derrick Pettit | Contractor | 6800 Nw 39th Ave. Lot 486, Coconut Creek, FL 33073 | 2010-10-18 |
| 1487713335 | John Algren Pettit | Optometrist | 1480 Us Highway 17 N, Inside Walmart Vision, Wauchula, FL 33873-5006 | 2006-12-07 |
| 1396823829 | John Pettit | Surgery | 1209 W Target Range Rd, Suite 4, Nogales, AZ 85621-2465 | 2006-11-01 |
| Street Address |
340 BIRCHWOOD AVE |
| City | BELLINGHAM |
| State | WA |
| Zip Code | 98225-1782 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043690126 | Bellingham Urology Group, Pllc | Clinic/Center | 340 Birchwood Ave, Bellingham, WA 98225-1782 | 2015-06-04 |
| 1497152631 | Bellingham Urology Group Pllc | Urology | 340 Birchwood Ave, Bellingham, WA 98225 | 2014-12-03 |
| 1437394939 | Denise Marie Taylor | Physician Assistant | 340 Birchwood Ave, Bellingham, WA 98225-1782 | 2008-12-11 |
| 1992828743 | Kelly June Casperson | Urology | 340 Birchwood Ave, Bellingham, WA 98225-1782 | 2007-04-09 |
| 1780722819 | Cascade Urology Surgery Center | Clinic/Center | 340 Birchwood Ave, Bellingham, WA 98225-1782 | 2007-02-01 |
| 1467537951 | Bellingham Urology Specialists Pllc | Clinic/Center | 340 Birchwood Ave, Bellingham, WA 98225-1782 | 2006-10-25 |
| 1417038019 | Bellingham Urology Specialists Pllc | Urology | 340 Birchwood Ave, Bellingham, WA 98225-1782 | 2006-10-18 |
| 1477634046 | Sean Casey Okeefe | Urology | 340 Birchwood Ave, Bellingham, WA 98225-1782 | 2006-10-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578183729 | Family Care Network Pllc | Clinic/Center | 3548 Meridian St, Suite #101-b, Bellingham, WA 98225 | 2020-04-17 |
| 1770129264 | Ariella K Ross | Massage Therapist | 2701 Northwest Avenue, Bellingham, WA 98225 | 2019-11-20 |
| 1467006205 | Family Care Network, Pllc | Family Medicine | 805 W. Orchard Drive, Suite 6, Bellingham, WA 98225 | 2019-07-30 |
| 1487110375 | Rhonda Beth Steel | Massage Therapist | Fairhaven Harbor, 1310 9th Street Penthouse No. 504, Fairhaven/bellingham, WA 98225 | 2019-02-15 |
| 1366915316 | Alexander Knight Acupuncture Inc | Acupuncturist | 12 Bellwether Way, Suite 201, Bellingham, WA 98225 | 2019-01-02 |
| 1902372998 | Northwest Telepsychiatry, Pllc | Psychiatry & Neurology | 114 W. Magnolia St., Suite 505, Bellingham, WA 98225 | 2018-10-17 |
| 1639650336 | Jennifer Sue Cogen | Massage Therapist | 2701 Northwest Ave. (ohana Pacific, Inc.), Bellingham, WA 98225 | 2018-08-22 |
| 1013414036 | Tamara C Dee | Social Worker | 1313 E Maple St Ste 229, Bellingham, WA 98225 | 2018-04-06 |
| 1417468596 | Samantha Grace Smith | Counselor | 920 Harris Avenue, 202-e, Bellingham, WA 98225 | 2017-10-17 |
| 1710406731 | Shalom Maria Shreve | Counselor | 1133 Railroad Ave., Suite 100, Bellingham, WA 98225 | 2017-09-11 |
| Find all providers in zip 98225 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023400041 | Pacific Northwest Urology Specialists, Pllc | Urology | 4545 Cordata Pkwy Ste 1a, Bellingham, WA 98226-7264 | 2015-02-27 |
| 1023366283 | William P Griggs | Urology | 2160 Dellesta Dr, Bellingham, WA 98226-7850 | 2012-08-20 |
| 1295883700 | Pacific Rim Urology | Urology | 2980 Squalicum Parkway, Suite 306, Bellingham, WA 98225 | 2007-01-08 |
| 1992207278 | Elizabeth Hirshberg | Urology | 3232 Squalicum Pkwy, Bellingham, WA 98225-1932 | 2018-03-02 |
| 1497152631 | Bellingham Urology Group Pllc | Urology | 340 Birchwood Ave, Bellingham, WA 98225 | 2014-12-03 |
| 1134414477 | Daniel Reznicek | Urology | 4545 Cordata Pkwy, Suite 1a, Bellingham, WA 98226-7263 | 2011-06-15 |
| 1992828743 | Kelly June Casperson | Urology | 340 Birchwood Ave, Bellingham, WA 98225-1782 | 2007-04-09 |
| 1417038019 | Bellingham Urology Specialists Pllc | Urology | 340 Birchwood Ave, Bellingham, WA 98225-1782 | 2006-10-18 |
| 1477634046 | Sean Casey Okeefe | Urology | 340 Birchwood Ave, Bellingham, WA 98225-1782 | 2006-10-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295371532 | Jeffrey Allen Zhan | Urology | Good Samaritan Medical Office Bldg 1450 5th St Se, Suite 2100- Urology Clinic, Puyallup, WA 98372 | 2019-11-21 |
| 1598182818 | Boston Medical Group- Washington, P.C. | Urology | 12301 N.e. 10th Place, Suite 101, Bellevue, WA 98005 | 2014-03-25 |
| 1033552823 | Carol Collins | Urology | 272 Health Sciences, 1959 Ne Pacific St, Seattle, WA 98195-7610 | 2013-04-10 |
| 1740523158 | Kacey Helena Provenzano | Urology | 780 Swift Blvd Ste 201, Richland, WA 99352 | 2013-04-03 |
| 1710242714 | Ralph Vernon Stagner | Urology | 3414 Horsehead Bay Dr. N.w., Gig Harbor, WA 98335 | 2012-07-06 |
| 1043579980 | Richard Kenneth Ohme | Urology | 3108 E Bay Dr Nw, Gig Harbor, WA 98335-7610 | 2012-05-13 |
| 1730447731 | Daniel Christian Sackman | Urology | 3124 South 19th St #c320, Tacoma, WA 98405-3011 | 2012-04-26 |
| 1144595299 | Philip Clark May | Urology | 11911 Ne 132nd St Ste 200, Kirkland, WA 98034 | 2012-03-21 |
| 1073886438 | Peter John Minich | Urology | 3124 S 19th St Ste 240, Tacoma, WA 98405-2433 | 2012-02-15 |
| 1366731887 | Helena Chih-hua Chang | Urology | 1536 N 115th St Ste 300, Seattle, WA 98133-8400 | 2011-04-05 |
| Find all providers with the same taxonomy | ||||
| City | BELLINGHAM |
| Zip Code | 98225 |
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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.