CARLA WILSON PETTY (NPI# 1578913646) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578913646 |
| Entity Type | Individual |
| Full Name | CARLA WILSON PETTY |
| Credential | NP-C |
| Practice Address |
1120 15th St Augusta GA 30912-1526 |
| Mailing Address |
1120 15th St Ste Bi1056 Augusta GA 30912-0004 |
| Practice Telephone | 7067218623 |
| Practice Fax Number | 7067211459 |
| Mailing Telephone | 7067213813 |
| Enumeration Date | 2016-06-20 |
| Last Update Date | 2020-08-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | RN211008 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363L00000X | Nurse Practitioner | 1-121795 | AL | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1348 Walton Way, Suite 4300, Augusta, GA 309015104 | 7067224300 | 7067227337 |
| 1898 Mulberry St, Montgomery, AL 361061526 | 3342397059 | 3342397841 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427516723 | Carla Monique Petty | Social Worker | 337 E 17th St, New York, NY 10003-3804 | 2019-03-05 |
| Street Address |
1120 15TH ST |
| City | AUGUSTA |
| State | GA |
| Zip Code | 30912-1526 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427051556 | Gyanendra Kumar Sharma | Internal Medicine | 1120 15th St, Augusta, GA 30912-0004 | 2005-05-23 |
| 1912508532 | Lacey Nichol Preston | Physician Assistant | 1120 15th St, Augusta, GA 30912-0004 | 2020-11-02 |
| 1992302988 | Victoria Mae Pregibon | Physician Assistant | 1120 15th St, Augusta, GA 30912-0004 | 2020-10-03 |
| 1275130239 | Tanya Renee Hall | Nurse Practitioner | 1120 15th St, Augusta, GA 30912-0004 | 2020-10-02 |
| 1144847864 | Cassandra Marie Voong | Internal Medicine | 1120 15th St, Augusta, GA 30912-0004 | 2020-06-29 |
| 1245857002 | Morgan Rowe | Nurse Practitioner | 1120 15th St, Augusta, GA 30912-0004 | 2020-06-28 |
| 1639795990 | Lauren Christine Bush | Audiologist | 1120 15th St, Augusta, GA 30912-0004 | 2020-06-23 |
| 1811513575 | Ashley Danielle Fox | Internal Medicine | 1120 15th St, Augusta, GA 30912-0006 | 2020-06-18 |
| 1265058994 | Matthew Craddock | Psychiatry & Neurology | 1120 15th St, Augusta, GA 30912-0004 | 2020-06-18 |
| 1437775301 | Joseph John Arellano | Emergency Medicine | 1120 15th St, Augusta, GA 30912-0004 | 2020-06-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548885940 | Hannah Gullickson Folsom | Family Medicine | 1459 Laney Walker Blvd Ae 3042, Augusta, GA 30912 | 2020-06-11 |
| 1487278909 | Robert Kennedy | Internal Medicine | Augusta University Internal Medicine Residency Program, 1120 15th Street, Bi 5070, Augusta, GA 30912 | 2020-06-01 |
| 1952968737 | Kayla M. Lasota | Pediatrics | 11230 115th St Ae3042, Augusta, GA 30912 | 2019-05-28 |
| 1003379280 | Kayla Cox | Internal Medicine | 1120 15th St Bi5070, Augusta, GA 30912 | 2019-04-13 |
| 1619435740 | Justin Ray Mackert | Student in an Organized Health Care Education/Training Program | Augusta University, 1120 15th Street, Gc 5110, Augusta, GA 30912 | 2019-03-07 |
| 1417444167 | Victor Celis | Dentist | John Wesley Gilbert Dr, Augusta, GA 30912 | 2018-04-18 |
| 1487157921 | Julie Ann Matsen | Student in an Organized Health Care Education/Training Program | 997 St. Sebastian Way, Eg-2021-10, Augusta Univ., Dept. of Psychiatry & Health Behavior, Augusta, GA 30912 | 2018-03-12 |
| 1497287031 | Luke Yuung-jier Chang | Ophthalmology | 1120 15th St # Ba2720, Augusta, GA 30912 | 2017-04-02 |
| 1821537622 | Lashawn Kay Boone | Nurse Practitioner | 1445 Harper St, Augusta, GA 30912 | 2017-02-14 |
| 1134675564 | Arnab Saha | Internal Medicine | 1120 15 Th St., Augusta, GA 30912 | 2016-08-26 |
| Find all providers in zip 30912 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588145106 | Stephanie Madeline Wright | Nurse Practitioner | 1120 15th St # Ad3401, Augusta, GA 30912-0004 | 2018-08-22 |
| 1841732807 | Robert Dean Whigham | Nurse Practitioner | 1510 C and S Dr, Augusta, GA 30909-2804 | 2016-11-08 |
| 1659731313 | Robin Ann Lockhart | Nurse Practitioner | 1120 15th St Ba-9413, Augusta, GA 30912 | 2016-02-24 |
| 1598137481 | Jason E Stephens | Nurse Practitioner | 1224 Augusta West Parkway, Augusta, GA 30909 | 2015-10-30 |
| 1063892644 | Jasneth James | Nurse Practitioner | 3301 Woodville Rd, Augusta, GA 30909-9228 | 2015-06-09 |
| 1932588837 | Audrey Chrisitne Usry | Nurse Practitioner | 1941 Phinizy Rd, Augusta, GA 30906-5173 | 2015-05-26 |
| 1114138013 | Denise Kim Drake | Nurse Practitioner | 3624 J Dewey Gray Cir Ste 110, Augusta, GA 30909-6585 | 2007-05-24 |
| 1710194840 | Au Nursing Associates, Inc. | Nurse Practitioner | 987 Saint Sebastian Way # Ec-1500, Augusta, GA 30912 | 2007-05-17 |
| 1396899167 | Laura J Logue | Nurse Practitioner | 1411 Laney Walker Blvd # An2206, Mcg Cancer Center, Augusta, GA 30912-0002 | 2007-01-22 |
| 1154481448 | Focused Wound Care Associates LLC | Nurse Practitioner | 263 Clay St, Augusta, MO 63332-1018 | 2006-12-09 |
| Find all providers in AUGUSTA | ||||
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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.