DR. BRETT JUSTIN PETTETT (NPI# 1891139572) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891139572 |
| Entity Type | Individual |
| Full Name | DR. BRETT JUSTIN PETTETT |
| Credential | M.D. |
| Practice Address |
3045 S National Ave Ste 110 Springfield MO 65804-4268 |
| Practice Telephone | 4178205610 |
| Mailing Telephone | 4178205610 |
| Enumeration Date | 2013-04-24 |
| Last Update Date | 2019-08-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XX0801X |
Orthopaedic Surgery Specialization: Orthopaedic Trauma |
2019009470 | MO | Allopathic & Osteopathic Physicians |
| N | 207XX0801X |
Orthopaedic Surgery Specialization: Orthopaedic Trauma |
MD464204 | PA | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 130 Mason Farm Rd, Department of Orthopaedics, Chapel Hill, NC 275996134 | 9199669071 | 9199666730 |
| 1307 Federal St Ste 2, Pittsburgh, PA 15212 | 4123594212 |
| Street Address |
3045 S NATIONAL AVE STE 110 |
| City | SPRINGFIELD |
| State | MO |
| Zip Code | 65804-4268 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033299987 | Dennis Sale | Family Medicine | 3045 S National Ave Ste 110, Springfield, MO 65804-4268 | 2006-10-16 |
| 1255844429 | April Jean Bensing | Nurse Practitioner | 3045 S National Ave Ste 110, Springfield, MO 65804-4268 | 2017-11-09 |
| 1740574490 | Anita Gopal Unnithan | Pediatrics | 3045 S National Ave Ste 110, Springfield, MO 65804-4268 | 2011-05-29 |
| 1376835215 | Ashley Lauren Crisp | Family Medicine | 3045 S National Ave Ste 110, Springfield, MO 65804-4268 | 2011-05-11 |
| 1124323001 | Kelbie B. Abercrombie | Physician Assistant | 3045 S National Ave Ste 110, Springfield, MO 65804 | 2011-01-24 |
| 1578797148 | Anthony James Bell | Orthopaedic Surgery | 3045 S National Ave Ste 110, Springfield, MO 65804-4247 | 2009-05-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790393049 | Kathy Forson | Nurse Practitioner | 1235 E. Cherokee St., Springfield, MO 65804 | 2020-07-22 |
| 1306498779 | Anne B Summers, LLC | Social Worker | 1310 E. Kingsley St., Ste C, Springfield, MO 65804 | 2019-07-15 |
| 1790241800 | Margaret Mary Hart | Social Worker | 1845 S Rogers Ave, Springfield, MO 65804 | 2019-02-13 |
| 1598254666 | Casey Carr | Optometrist | 1229 E Seminole St Ste 110, Springfield, MO 65804 | 2018-05-04 |
| 1124520697 | Shelby D White | Behavioral Analyst | 1300 E. Bradford Parkway, Springfield, MO 65804 | 2018-03-01 |
| 1316448343 | Karl Lynham | Massage Therapist | 1200 E Woodhurst Dr R300, Springfield, MO 65804 | 2018-02-25 |
| 1699273763 | Leah Wilson | Counselor | 1322 E Woodgate, Springfield, MO 65804 | 2018-01-24 |
| 1295242626 | Matthew Crisp | Physical Therapist | 3252 E Independence St, Springfield, MO 65804 | 2018-01-08 |
| 1518491042 | Crystal Spangler | Dietitian, Registered | 1965 S Fremont Ave Ste 220, Springfield, MO 65804 | 2017-04-11 |
| 1588012033 | Jeffrey Williams | Pharmacist | 1235 E. Cherokee, Springfield, MO 65804 | 2016-05-25 |
| Find all providers in zip 65804 | ||||
| Taxonomy Code | 207XX0801X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Orthopaedic Trauma |
| Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic trauma surgeons deal with the evaluation and management of acute orthopaedic injuries, evaluation and treatment of post-traumatic deformities and nonunions, acute and delayed reconstruction of pelvic and acetabular fractures, as well as osteotomy in the adult hip for treatment of hip arthritis. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Separate board certification is not currently offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245434828 | David Joshua Merriman | Orthopaedic Surgery | 1229 E Seminole St, Ste 230, Springfield, MO 65804-2227 | 2007-06-14 |
| 1912123134 | Matthew Paul Gardner | Orthopaedic Surgery | 800 N 1st St, Springfield, IL 62702-3719 | 2007-04-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033762570 | Mandip Singh | Orthopaedic Surgery | 3635 Vista Ave Fl 7, Saint Louis, MO 63110-2539 | 2019-07-23 |
| 1700396298 | Lana Kay Foust | Orthopaedic Surgery | 3429 Harrison St # 1n, Kansas City, MO 64109-2912 | 2017-10-10 |
| 1932581683 | Erin Lyn Hofer | Orthopaedic Surgery | 4921 Parkview Pl, Ste 6a/6b/12a, Saint Louis, MO 63110-1032 | 2015-06-18 |
| 1790195824 | Justin Ulip Tilan | Orthopaedic Surgery | 4921 Parkview Pl, Ste 6a/6b/12a, Saint Louis, MO 63110-1032 | 2014-04-29 |
| 1982014130 | Lauren Maccormick Tatman | Orthopaedic Surgery | 4921 Parkview Pl, Ste 6a/6b/12a, Saint Louis, MO 63110-1032 | 2014-04-28 |
| 1396067328 | Seth Gengler | Orthopaedic Surgery | 621 S New Ballas Rd Ste 5015b, Saint Louis, MO 63141-8270 | 2010-02-17 |
| 1477764504 | Anna Noel Miller | Orthopaedic Surgery | 4921 Parkview Pl, Ste 6a/6b/12a, Saint Louis, MO 63110-1032 | 2007-05-24 |
| 1336354760 | Christopher M Mcandrew | Orthopaedic Surgery | 4921 Parkview Pl Ste 6a6b, Ste 6a/6b, Saint Louis, MO 63110-1032 | 2007-05-11 |
| 1114139003 | St Louis University | Orthopaedic Surgery | 1755 S Grand Blvd, Saint Louis, MO 63104-1540 | 2007-05-04 |
| 1073737144 | Zachary V Roberts | Orthopaedic Surgery | 19550 E 39th St S Ste 410, Independence, MO 64057-2307 | 2007-04-12 |
| Find all providers with the same taxonomy | ||||
| City | SPRINGFIELD |
| Zip Code | 65804 |
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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.