DR. BENJAMIN J PETTUS (NPI# 1770596959) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770596959 |
| Entity Type | Individual |
| Full Name | DR. BENJAMIN J PETTUS |
| Credential | M.D., PHD |
| Practice Address |
500 J. Clyde Morris Blvd Riverside Regional Medical Center Newport News VA 23601-1929 |
| Mailing Address |
P O Box 12087 Newport News VA 23612-2087 |
| Practice Telephone | 7575944405 |
| Practice Fax Number | 7578676587 |
| Mailing Telephone | 7578676102 |
| Mailing Fax Number | 7578676587 |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2012-01-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
0101249325 | VA | Allopathic & Osteopathic Physicians |
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
2010003256 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | RAILROAD MEDICARE | P00980578 | 01 |
| Street Address |
500 J. CLYDE MORRIS BLVD RIVERSIDE REGIONAL MEDICAL CENTER |
| City | NEWPORT NEWS |
| State | VA |
| Zip Code | 23601-1929 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891781571 | Timothy P. Farrell | Radiology | 500 J. Clyde Morris Blvd, Riverside Regional Medical Center, Newport News, VA 23601-1929 | 2005-09-27 |
| 1174152961 | Zacharia Nayer | Student in an Organized Health Care Education/Training Program | 500 J. Clyde Morris Blvd, Dept. of Medical Education/annex: Second Floor, Newport News, VA 23601 | 2020-04-03 |
| 1760811004 | Deadra Maxwell | Registered Nurse | 500 J. Clyde Morris Blvd, Riverside Regional Medical Center, Newport News, VA 23601-1758 | 2013-11-07 |
| 1164745147 | Terienne R Dortman | Nurse Anesthetist, Certified Registered | 500 J. Clyde Morris Blvd, Riverside Regional Medical Center, Newport News, VA 23601-1929 | 2010-03-05 |
| 1124289442 | Nicole Jean-watring Nelson | Emergency Medicine | 500 J. Clyde Morris Blvd, Department of Emergency Medicine, Newport News, VA 23601 | 2008-06-19 |
| 1073578811 | Anna Gyurjyan | Nurse Practitioner | 500 J. Clyde Morris Blvd, Bld G, Newport News, VA 23601 | 2006-04-17 |
| 1801876677 | James Mccall Grimson | Radiology | 500 J. Clyde Morris Blvd, Riverside Regional Medical Center, Newport News, VA 23601-1929 | 2006-01-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740809235 | Joshua Alan Albert | Student in an Organized Health Care Education/Training Program | Riverside Family Medicine Center 10510 Jefferson Ave, Suite A, Newport News, VA 23601 | 2020-04-14 |
| 1053959957 | Sisters In Homecare LLC | Home Health | 716 J Clyde Morris Blvd, Newport News, VA 23601 | 2019-12-11 |
| 1811450638 | Kevin Lavender | Student in an Organized Health Care Education/Training Program | Riverside Brentwood Medical Center, 10510 Jefferson Avenue Suite A, Newport News, VA 23601 | 2019-04-09 |
| 1578025532 | Cortlandt Mercy Sellers | Student in an Organized Health Care Education/Training Program | Riverside Regional Medical Center, 500 J Clyde Morris Blvd, 2 Annex, Newport News, VA 23601 | 2019-04-01 |
| 1407352974 | Stephen Leinfelder | Student in an Organized Health Care Education/Training Program | 500 J. Clyde Morris Blvd., Dept. of Medical Education, Second Floor Annex, Newport News, VA 23601 | 2018-04-03 |
| 1104359132 | Nicholas Alexander Austin | Student in an Organized Health Care Education/Training Program | 500 J. Clyde Morris Blvd., Second Floor Annex, Riverside Transitional Internship Program, Newport News, VA 23601 | 2017-04-06 |
| 1609312883 | Bright Nii Lante Lamptey | Pharmacist | 600 J Clyde and Morris Blvd, Newport News, VA 23601 | 2017-01-12 |
| 1417490517 | Justin Chamblee | Pharmacist | 671 J. Clyde Morris Blvd, Newport News, VA 23601 | 2016-11-22 |
| 1447706080 | Megan Elizabeth Cobb | Physician Assistant | 500 J Clyde Morrisl Blvd, Suite 603, Newport News, VA 23601 | 2016-09-01 |
| 1669815957 | Christina Michelle Wray Mcmillan | Nurse Practitioner | 416 J. Clyde Morris Blvd., Newport News, VA 23601 | 2013-04-17 |
| Find all providers in zip 23601 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| 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 Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972712115 | Jeffrey Allen Vandesand | Radiology | 860 Omni Blvd Ste 109, Newport News, VA 23606-4430 | 2007-05-22 |
| 1164536942 | Curtis Doane Stoldt | Radiology | 894 Middle Ground Blvd, Riverside Diagnostice Imaging and Breast Center, Newport News, VA 23606 | 2006-08-18 |
| 1245254077 | Randall A Sikes | Radiology | 500 J Clyde Morris Blv, Riverside Regional Medical Center, Newport News, VA 23601 | 2006-07-26 |
| 1891781571 | Timothy P. Farrell | Radiology | 500 J. Clyde Morris Blvd, Riverside Regional Medical Center, Newport News, VA 23601-1929 | 2005-09-27 |
| 1174522551 | Richard Ohagan | Radiology | 813 Diligence Dr, Ste 108, Newport News, VA 23606-4237 | 2005-07-19 |
| 1205246741 | Jonathan Daniel Lewis | Radiology | 500 J Clyde Morris Blvd, Riverside Regional Medical Center, Newport News, VA 23601-1929 | 2014-05-06 |
| 1972941797 | Yankai Sun | Radiology | 500 J Clyde Morris Blvd, Riverside Regional Medical Center, Newport News, VA 23601-1929 | 2013-06-14 |
| 1720349236 | Adrian Repic | Radiology | 500 J Clyde Morris Blvd, Riverside Regional Medical Center, Newport News, VA 23601-1929 | 2012-05-31 |
| 1780940593 | Ryan P Holste | Radiology | 500 J Clyde Morris Blvd, Riverside Regional Medical Center, Newport News, VA 23601-1929 | 2012-04-05 |
| 1760778518 | Hosam Nabil Attaya | Radiology | 12200 Warwick Blvd, Ste. 490a, Newport News, VA 23601-2344 | 2011-06-21 |
| Find all providers in NEWPORT NEWS | ||||
| City | NEWPORT NEWS |
| Zip Code | 23601 |
Please comment or provide details below to improve the information on DR. BENJAMIN J PETTUS.
| 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.