DERRY PETTY (NPI# 1558812214) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1558812214 |
Entity Type | Individual |
Full Name | DERRY PETTY |
Credential | LMT |
Practice Address |
337 Oak Grove Ave Apt I Jackson MI 49203-1394 |
Practice Telephone | 5174165297 |
Mailing Telephone | 5174165297 |
Enumeration Date | 2016-10-18 |
Last Update Date | 2016-10-29 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 225700000X | Massage Therapist | 7501006216 | MI | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Street Address |
337 OAK GROVE AVE APT I |
City | JACKSON |
State | MI |
Zip Code | 49203-1394 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1760900120 | Cynthia A Rider Dmd Pllc | Oral & Maxillofacial Surgery | 2545 Spring Arbor Road, Suite 202, Jackson, MI 49203 | 2017-09-06 |
1407224280 | Lucinda Gail Taggart | Licensed Practical Nurse | 1515 Greenwood Ave., Jackson, MI 49203 | 2015-09-10 |
1134514045 | Christopher Dauterman | Registered Nurse | 1320 East Mcdevitt, Jackson, MI 49203 | 2015-03-30 |
1710386826 | Steven Andrew Edwards | Social Worker | 505 Hickory Court, #2d, Jackson, MI 49203 | 2014-08-14 |
1861800666 | Michigan Continuum Care Pllc | Internal Medicine | 1310 Greenwood Ave., Jackson, MI 49203 | 2014-07-25 |
1497014831 | Barbara Cliffe-miller | Physical Therapist | 3510 Page Ave, Jackson, MI 49203 | 2012-05-04 |
1871822718 | Sharon Ann Arendsen | Respite Care | 4043 Clarkway Rd, Jackson, MI 49203 | 2009-12-23 |
1669700456 | Teresa Lynn Cox | Technician, Other | 3884 Franklin Rd., Jackson, MI 49203 | 2009-12-07 |
1942537097 | Stacy Marie Chinevere I | Counselor | 326 Johnson St, Jackson, MI 49203 | 2009-11-11 |
1366672370 | Sarah Elizabeth Hazlett | Counselor | 1522joy Avenue, Jackson, MI 49203 | 2009-07-24 |
Find all providers in zip 49203 |
Taxonomy Code | 225700000X |
Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Classification | Massage Therapist |
An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1275154338 | Crystal Edwards | Massage Therapist | 2718 Medgar Evers Blvd, Jackson, MS 39213-7257 | 2020-04-30 |
1568093367 | Choice Chiropractic Pllc | Massage Therapist | 3343 Spring Arbor Rd Ste 300, Jackson, MI 49203-8623 | 2020-01-30 |
1821631474 | Sherry J Miller | Massage Therapist | 18 Brentshire Sq Ste A, Jackson, TN 38305-2203 | 2019-10-25 |
1881236479 | Donna Summers | Massage Therapist | 761 Woodlake Dr, Jackson, MS 39206-2219 | 2019-10-15 |
1689221574 | Tanya Karr | Massage Therapist | 847 N Highway 49-88 Ste 4, Jackson, CA 95642-2013 | 2019-08-24 |
1285295881 | Melissa Tittler | Massage Therapist | 119 Kenneth St, Jackson, MI 49203-1083 | 2019-06-25 |
1245754563 | Tanika Annette Gillard | Massage Therapist | 4 Hampton Ln, Jackson, TN 38305 | 2017-07-28 |
1619407046 | Edwind Allen Holsey | Massage Therapist | 908 Union St, Jackson, MI 49203-2897 | 2017-06-18 |
1194171728 | Angelina Bey | Massage Therapist | 1296 N Highland Ave, Ste 6, Jackson, TN 38301-4085 | 2016-05-12 |
1235593864 | Martine Stevenson | Massage Therapist | 2905 Heritage Place Blvd, Apt# 4, Jackson, MI 49203-2276 | 2016-04-10 |
Find all providers in JACKSON |
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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.