MR. JOHN ALTON PETTAY (NPI# 1902851645) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902851645 |
| Entity Type | Individual |
| Full Name | MR. JOHN ALTON PETTAY |
| Credential | FNP C |
| Practice Address |
2295 Henry Clower Blvd Suite 101 Snellville GA 30078 |
| Mailing Address |
1105 Pebble Bend Drive Grayson GA 30017 |
| Practice Telephone | 7709724871 |
| Practice Fax Number | 7709793782 |
| Mailing Telephone | 7709852845 |
| Mailing Fax Number | 7709852845 |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2009-01-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
RN107083 NP | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2295 HENRY CLOWER BLVD SUITE 101 |
| City | SNELLVILLE |
| State | GA |
| Zip Code | 30078 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528035011 | Akil A Patel | Dentist | 2295 Henry Clower Blvd, Ste. 100, Snellville, GA 30078-5707 | 2006-03-02 |
| 1831639483 | Heather Nicole Brown | Occupational Therapist | 2295 Henry Clower Blvd, Suite 100, Snellville, GA 30078-5707 | 2017-03-01 |
| 1831638147 | Casi Johnson | Speech-Language Pathologist | 2295 Henry Clower Blvd, Snellville, GA 30078-5707 | 2017-02-20 |
| 1750831590 | Allya Allaway | Occupational Therapy Assistant | 2295 Henry Clower Blvd, Suite 100, Snellville, GA 30078-5707 | 2016-10-05 |
| 1720336621 | Madison Johnson | Speech-Language Pathologist | 2295 Henry Clower Blvd, Suite 100, Snellville, GA 30078-5707 | 2012-08-27 |
| 1922372481 | Maria Renee Lindsey | Speech-Language Pathologist | 2295 Henry Clower Blvd, Suite 100, Snellville, GA 30078-5707 | 2012-03-01 |
| 1124126420 | John E. West, M.d., P.C. | Family Medicine | 2295 Henry Clower Blvd, Suite 101, Snellville, GA 30078-5707 | 2006-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619594561 | Steven Nguyen | Optometrist | 1905 Scenic Hwy S #1130, Snellville, GA 30078 | 2020-06-26 |
| 1891320776 | Youstina Harkas | Optometrist | 1679 Scenic Hwy S 203, Snellville, GA 30078 | 2020-03-11 |
| 1578101127 | Jwwt Neuoromonitoring, LLC | Psychiatry & Neurology | 1350 Scenic Highway, Suite 266, Snelville, GA 30078 | 2019-12-13 |
| 1679119903 | Lashon Poole Wells | Social Worker | 1350 Scenic Highway Ste 266, 1350 Scenic Highway Ste 266, Snellville, GA 30078 | 2019-11-21 |
| 1427601426 | Aemad Heavenly Joy Senior Homecare & Developmental Disabilities LLC | Registered Nurse | 1350 Scenic Highway Suite #266, Sneville, GA 30078 | 2019-07-18 |
| 1063975548 | Joanne Mcdougal Patterson | Nurse Practitioner | 1350 Scenic Hwy N Ste 226, Snellville, GA 30078 | 2019-04-10 |
| 1689144263 | Israel Branford | Physical Therapist | 1575 Scenic Hwy Ste 100, Snellville, GA 30078 | 2018-11-27 |
| 1902382997 | Brittany Dupree | Dermatology | 2383 Pate Street North, Snellville, GA 30078 | 2018-07-13 |
| 1134610926 | Reid Weston Popple | Dentist | 2992 Stone Mountain Hwy, A100, Snellville, GA 30078 | 2018-05-29 |
| 1326550492 | Optimal Healthcare Services LLC | Clinic/Center | 2121 Fountain Dr Ste F, Snellville, GA 30078 | 2017-10-30 |
| Find all providers in zip 30078 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902423163 | Ascende Healthcare | Nurse Practitioner | 2151 Fountain Dr Ste 301l, Snellville, GA 30078-6783 | 2020-07-02 |
| 1336764802 | Gwinnett Care At Home LLC | Nurse Practitioner | 3585 Edenderry Dr, Snellville, GA 30039-5961 | 2020-06-10 |
| 1255967246 | Nelly Osakwe-ozumba | Nurse Practitioner | 2994 Bridgehaven Ct, Snellville, GA 30039-7334 | 2020-03-21 |
| 1891345823 | Rory Lyn Hunkele | Nurse Practitioner | 1700 Tree Ln Ste 390, Snellville, GA 30078-6744 | 2019-09-11 |
| 1992268908 | Marjean Tyndale | Nurse Practitioner | 2800 Lake Port Dr, Snellville, GA 30039-5452 | 2019-04-08 |
| 1194207126 | April Anita Bright | Nurse Practitioner | 3850 Mountain Cove Rd, Snellville, GA 30039-8429 | 2018-09-06 |
| 1245716505 | Kasey Lila Lieu | Nurse Practitioner | 3020 Centerville Hwy, Snellville, GA 30039-4614 | 2018-07-19 |
| 1740782002 | Krystal Allen | Nurse Practitioner | 3381 Open Fields Dr, Snellville, GA 30078-4573 | 2018-03-02 |
| 1245740372 | Carolyn Turner Lawson | Nurse Practitioner | 1600 Medical Way Ste 200, Snellville, GA 30078-2160 | 2017-10-03 |
| 1891204640 | Melanie Tyler-payton | Nurse Practitioner | 3672 Zoey Lee Dr, Snellville, GA 30039-5302 | 2017-09-25 |
| Find all providers in SNELLVILLE | ||||
| City | SNELLVILLE |
| Zip Code | 30078 |
Please comment or provide details below to improve the information on MR. JOHN ALTON PETTAY.
| 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.