DR. ERICKA M. RUSSELL PETTY (NPI# 1659362705) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659362705 |
| Entity Type | Individual |
| Full Name | DR. ERICKA M. RUSSELL PETTY |
| Other Name | DR. ERICKA M. RUSSELL-PETTY |
| Credential | M.D. |
| Practice Address |
3710 Waters Ave Savannah GA 31404-6209 |
| Mailing Address |
5710 Ogeechee Rd Ste 200 Box 283 Savannah GA 31405-9515 |
| Practice Telephone | 9127775490 |
| Practice Fax Number | 9127775491 |
| Mailing Telephone | 9127775490 |
| Mailing Fax Number | 9127775491 |
| Enumeration Date | 2005-10-28 |
| Last Update Date | 2013-08-13 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 047258 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000880448D | 05 | |
| GA | 000880448C | 05 | |
| GA | 000880448E | 05 | |
| GA | 000880448H | 05 |
| Street Address |
3710 WATERS AVE |
| City | SAVANNAH |
| State | GA |
| Zip Code | 31404-6209 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215483128 | Peds Health | Clinic/Center | 3710 Waters Ave, Savannah, GA 31404-6209 | 2016-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043864580 | Carli A Boatright | Registered Nurse | 4750 Waters Ave Suite 206, Savannah, GA 31404 | 2019-08-01 |
| 1619530573 | Morgan Johnson | Student in an Organized Health Care Education/Training Program | Memorial Health University Medical Center, 4700 Waters Ave, Savannah, GA 31404 | 2019-04-17 |
| 1477050243 | Kevin Timperman | Student in an Organized Health Care Education/Training Program | 4700 Waters Avenus, Surgery Residency Program, Mhumc, Savannah, GA 31404 | 2018-04-09 |
| 1376048959 | Nina Jo Paletta | Student in an Organized Health Care Education/Training Program | Memorial University Medical Center, 4700 Waters Ave., Savannah, GA 31404 | 2018-03-27 |
| 1972036200 | Jose Adrian Lara Gonzalez | Student in an Organized Health Care Education/Training Program | 4700 Waters Ave, Memorial University Medical Center, Internal Medicine Residency Program, Savannah, GA 31404 | 2017-04-04 |
| 1407210396 | Lexie Hester Vaughn | Student in an Organized Health Care Education/Training Program | 1250 East 66th St, Savannah, GA 31404 | 2016-04-07 |
| 1336503291 | Miles Love | Student in an Organized Health Care Education/Training Program | 1250 East 66th Street, Savannah, GA 31404 | 2016-04-07 |
| 1134536881 | David Patch | Specialist/Technologist | Pediatric Residency Program, Memorial University, Medical Center 4700 Waters Avenue, Savannah, GA 31404 | 2014-07-15 |
| 1962846683 | Alan Danilo Zevallos | Internal Medicine | 4700 Waters Avenue, University Medical Center, Internal Medicine Residency Program, Memorial Health, Savannah, GA 31404 | 2013-04-24 |
| 1730446394 | Joshua Ryan Fann | Prosthetist | 3840 Waters Ave, Savannah, GA 31404 | 2012-04-19 |
| Find all providers in zip 31404 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| 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 Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851525745 | Adesuwa Igbinedion | Pediatrics | 150 East End Dr., Savannah, TN 38372-1712 | 2009-05-07 |
| 1932252244 | Pediatric Associates of Savannah, P.C. | Pediatrics | 4600 Waters Ave Ste 100, Savannah, GA 31404-6274 | 2007-01-19 |
| 1275648560 | Charlene D Sojico | Pediatrics | 4849 Paulsen Street, Suite 208, Savannah, GA 31405-4425 | 2006-08-20 |
| 1912938366 | Linda J Winders | Pediatrics | 322 Stephenson Ave, Savannah, GA 31405-5998 | 2006-07-05 |
| 1932144532 | Kasey Reeves Berman | Pediatrics | 410 Mall Blvd Ste B, Savannah, GA 31406-4869 | 2006-06-18 |
| 1750341764 | W. Esther Mcalpine | Pediatrics | 4849 Paulsen St Ste 208, Savannah, GA 31405-4425 | 2006-03-24 |
| 1396732376 | Monica B Manocha | Pediatrics | 5102 Paulsen St, Building 3, Savannah, GA 31405-4601 | 2005-10-04 |
| 1629062468 | Robert J Shelley | Pediatrics | 4600 Waters Ave, Suite 100, Savannah, GA 31404-6702 | 2005-09-08 |
| 1225037112 | Jose Federico Rodriguez-curras | Pediatrics | 2 Wheeler St, Savannah, GA 31405-5700 | 2005-07-21 |
| 1487115614 | Kelsey Leigh Lofgren | Pediatrics | 4700 Waters Ave, Savannah, GA 31404-6220 | 2019-03-29 |
| Find all providers in SAVANNAH | ||||
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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.