DR. ADAM ADAIR PETTEY (NPI# 1629051677) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629051677 |
| Entity Type | Individual |
| Full Name | DR. ADAM ADAIR PETTEY |
| Credential | M.D. |
| Practice Address |
2120 Professional Dr Roseville CA 95661-3700 |
| Mailing Address |
1600 Eureka Rd Department of Dermatology Roseville CA 95661-3027 |
| Practice Telephone | 9167716662 |
| Mailing Telephone | 9167716662 |
| Enumeration Date | 2005-11-23 |
| Last Update Date | 2007-09-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | ME90875 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | BLUECROSS/BLUESHIELD | 48701 | 01 |
| Street Address |
2120 PROFESSIONAL DR |
| City | ROSEVILLE |
| State | CA |
| Zip Code | 95661-3700 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952823585 | Kaitlin Paige Leggins | Audiologist | 2120 Professional Dr, Roseville, CA 95661-3700 | 2017-07-14 |
| 1790914869 | Christopher Kevin Chiu | Surgery | 2120 Professional Dr, Roseville, CA 95661-3700 | 2009-07-09 |
| 1073776613 | Christine Badgwell Doherty | Dermatology | 2120 Professional Dr, Roseville, CA 95661-3700 | 2008-07-03 |
| 1578726121 | Sean David Doherty | Dermatology | 2120 Professional Dr, Roseville, CA 95661-3700 | 2008-07-03 |
| 1689853723 | Edith Marion Higgins | Acupuncturist | 2120 Professional Dr, Suite 210, Roseville, CA 95661-3700 | 2007-10-25 |
| 1124219944 | Dawn Zhao | Physical Therapist | 2120 Professional Dr, Roseville, CA 95661-3700 | 2007-08-06 |
| 1578765277 | Jean Lai | Physical Medicine & Rehabilitation | 2120 Professional Dr, Roseville, CA 95661-3700 | 2007-06-04 |
| 1962550848 | Matthew Straughn White | Audiologist | 2120 Professional Dr, Suite 220, Roseville, CA 95661-3700 | 2007-01-08 |
| 1831247154 | Steven Carlton Nolan | Audiologist | 2120 Professional Dr, Suite 220, Roseville, CA 95661-3700 | 2007-01-05 |
| 1649330010 | Man Han | Acupuncturist | 2120 Professional Dr, Suite 135, Roseville, CA 95661-3700 | 2006-12-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134777816 | Aprildawn Mccarty Mccarty | Behavior Technician | 2125 Professional Dr, 100, Roseville, CA 95661 | 2019-08-27 |
| 1407409089 | David Armel Gomez Croddy | Dentist | 2740 Carradale Drive, Roseville, CA 95661 | 2019-07-22 |
| 1699335612 | Mowell | Durable Medical Equipment & Medical Supplies | 901 Sunrise, Roseville, CA 95661 | 2019-06-20 |
| 1578024998 | Mystesia Lasan Hayes | Behavior Technician | 4121 Vittorio Dr., Roseville, CA 95661 | 2019-03-28 |
| 1033676457 | The Place Within | Counselor | 720 Sunrise Ave #d115, Roseville, CO 95661 | 2019-02-21 |
| 1396217733 | Tuyen Thi Thanh Nguyen | Respiratory Therapist, Registered | Kaiser Roseville Hospital, 1600 Eureka Rd, Roseville, CA 95661 | 2018-12-26 |
| 1982179776 | Dr. Jeffrey A. Saladin, Dental Corporation | Dentist | 1565 Eureka Road, Suite 5, Roseville, CA 95661 | 2018-10-08 |
| 1184106536 | Sabita Kondle | Marriage & Family Therapist | 1528 Hope Counseling Center Ste 101, Roseville, CA 95661 | 2018-09-02 |
| 1740787837 | Sylvia A Atieno | Nurse Practitioner | Suttter Roseville Medical Center, 1 Medical Plaza, Roseville, CA 95661 | 2018-04-06 |
| 1457875296 | Good Works Psychophysiology and Physical Therapy | Physical Therapist | 1650 Leadhill Blvd, 600, Roseville, CA 95661 | 2017-08-02 |
| Find all providers in zip 95661 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609296144 | Peter Jajou | Dermatology | 18285 E 10 Mile Rd Ste 130, Roseville, MI 48066 | 2014-04-23 |
| 1740411628 | Javier Rangel | Dermatology | 2120 Professional Dr # 140, Roseville, CA 95661-3700 | 2009-07-27 |
| 1598981763 | Kathryn Boyse Gant | Dermatology | 258 Gibson Dr, Ste 140, Roseville, CA 95678-5881 | 2007-04-17 |
| 1548366727 | Scott B Hearth | Dermatology | 1535 Eureka Rd, Roseville, CA 95661-3040 | 2006-09-15 |
| 1255447215 | Usha R Sood | Dermatology | 18285 Ten Mile Rd, Suite 130, Roseville, MI 48066 | 2006-08-22 |
| 1114940343 | Robert Hadley Hargrove | Dermatology | 10 Sierra Gate Plz Ste 120, Roseville, CA 95678-6647 | 2006-07-26 |
| 1508803263 | Roseville Dermatology Inc. | Dermatology | 1211 Pleasant Grove Blvd, Suite 100, Roseville, CA 95678-6971 | 2006-06-01 |
| 1184628000 | Gregory Michael Bricca | Dermatology | 9269 Sierra College Blvd, Roseville, CA 95661 | 2005-06-09 |
| 1003327545 | West Oak Dermatology Inc | Dermatology | 258 Gibson Dr, Ste 140, Roseville, CA 95678-5881 | 2017-10-23 |
| 1972856490 | Nalini G Prasad | Dermatology | 1650 Lead Hill Blvd, Suite 400, Roseville, CA 95661-3061 | 2012-10-22 |
| Find all providers in ROSEVILLE | ||||
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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.