SHALITA PETTWAY


Address: 7229 Pine Lakes Blvd, Port St Lucie, FL 34952
Phone: 7722146911

SHALITA PETTWAY (NPI# 1912309642) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1912309642
Entity Type Individual
Full Name SHALITA PETTWAY
Practice Address 7229 Pine Lakes Blvd
Port St Lucie
FL 34952
Mailing Address Po Box 8532
Hobe Sound
FL 33455
Practice Telephone 7722146911
Mailing Telephone 7722146911
Enumeration Date 2014-09-25
Last Update Date 2014-09-25
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 171M00000X Case Manager/Care Coordinator Other Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
FL MEDICARE & MEDICAID SERVICES CMS 171M000000X 01

Office Location

Street Address 7229 PINE LAKES BLVD
City PORT ST LUCIE
State FL
Zip Code 34952

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1215587068 Carehere LLC Family Medicine Carehere Clinic- St. Lucie Psl, 1680 Se Lyngate Drive, Port St Lucie, FL 34952 2019-09-13
1255998274 Morningside Alf Assisted Living Facility 2233 Se Mroningside Alf, Port Saint Lucie, FL 34952 2019-05-24
1336611870 Med Braces and Supplies, LLC Durable Medical Equipment & Medical Supplies 1484 Se Village Green Dr, Port St Lucie, FL 34952 2018-12-21
1689143794 The Gift of Recovery, LLC Counselor 1801 Sw Hillmoor Drive, Suite C-101, Port St. Lucie, FL 34952 2018-11-19
1457830853 Cathy L Sonier Counselor 357 Brazilian Circle, Port St Lucie, FL 34952 2018-08-07
1548756661 Blo 7 Diabetes Institute Inc Nutritionist 1700 Sw Hillmoor Dr., Suite 305, Port St. Lucie, FL 34952 2018-07-02
1780194464 Doctor's Choice Medical Center Clinic/Center 9164 S Us Highway 1, Port St Lucie, FL 34952 2017-10-06
1801305644 Thandiwe Daley Behavior Technician 1935 Se Hillmoor Drive, Apt#159, Port St Lucie, FL 34952 2017-09-25
1700309408 Lagrand Evan Andrews Assistant Behavior Analyst 265 Se Lenard Rd. Apartment 307, Port St. Lucie, FL 34952 2017-07-25
1578085148 Lavetta S Ivey Behavior Technician 7190 Us Federal Hwy 1, Port Saint Lucie, FL 34952 2017-07-14
Find all providers in zip 34952

Taxonomy Information

Taxonomy Code 171M00000X
Grouping Other Service Providers
Classification Case Manager/Care Coordinator

Taxonomy Definition

A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management.
Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1285284745 Ronn Daigle Case Manager/Care Coordinator 6701 Woods Island Cir Apt 105, Port St Lucie, FL 34952-1482 2019-09-17
1053872986 Marie E Solide Case Manager/Care Coordinator 1526 Sw Broadview St, Port St Lucie, FL 34983-2993 2019-03-25
1669941506 Linda Prevalon Case Manager/Care Coordinator 4602 Sw Joffre St, Port St Lucie, FL 34953-6638 2018-11-21
1922592864 Deadra L Nisbeth-lewis Case Manager/Care Coordinator 2312 Sw Import Dr, Port St Lucie, FL 34953-5796 2018-06-14
1073028072 Mayra Fitzgerald Case Manager/Care Coordinator 1201 Sw Thomas Ct, Port St Lucie, FL 34953-4271 2017-12-12
1124547989 Alicia Maria Herrero Marzo Case Manager/Care Coordinator 749 Nw Orchid St, Port St Lucie, FL 34983 2017-09-13
1912364886 Chastity Velez-soto Case Manager/Care Coordinator 702 Se White Ave, Port St Lucie, FL 34983-2672 2016-01-24
1801263736 Maria Entner Case Manager/Care Coordinator 11154 Sw Wyndham Way, Port St Lucie, FL 34987-2752 2015-08-26
1790177202 Freddy Chavarro Case Manager/Care Coordinator 237 Sw Sterret Cir, Port St Lucie, FL 34953-3325 2015-02-21
1083034649 Diana Capellan Case Manager/Care Coordinator 1479 Se Grapeland Ave, Port St Lucie, FL 34952-4949 2014-04-22
Find all providers in PORT ST LUCIE

Competitor

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City PORT ST LUCIE
Zip Code 34952

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Dataset Information

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.

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