MRS. DENISE MARIE PETTIT (NPI# 1669497152) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669497152 |
| Entity Type | Individual |
| Full Name | MRS. DENISE MARIE PETTIT |
| Other Name | DENISE MARIE RHOADS |
| Credential | PA-C |
| Practice Address |
101 Marcley Drive Martinsburg WV 25401 |
| Practice Telephone | 3042638911 |
| Practice Fax Number | 3042639450 |
| Mailing Telephone | 3042638911 |
| Mailing Fax Number | 3042639450 |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2020-05-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
01252 | WV | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
MA052197 | PA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | MEDICARE GROUP NUMBER | 9930421 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4803 Gerrardstown Rd, Inwood, WV 254283450 | 3048219011 | 3048219012 |
| 97 Administrative Dr Ste 200a, Martinsburg, WV 254046378 | 3043503230 | 3043503244 |
| Street Address |
101 MARCLEY DRIVE |
| City | MARTINSBURG |
| State | WV |
| Zip Code | 25401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962020537 | Christina Anne Williams | Nurse Practitioner | 2100 Hospital Drive, Martinsburg, WV 25401 | 2020-07-10 |
| 1013530633 | Pdi Health Wv LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 126 E. Burke Street, Martinsburg, WV 25401 | 2020-05-19 |
| 1699293035 | Tiffany Curry | Social Worker | 653 Winchester Avenue, Martinsburg, WV 25401 | 2017-09-06 |
| 1972042992 | Berkeley County Council | Counselor | 800 Emmett Rousch Drive, Martinsburg, WV 25401 | 2017-02-23 |
| 1023569449 | Heidi Crawford | Registered Nurse | 401 South College Street, Berkeley County Board of Ed, Martinsburg, WV 25401 | 2016-10-20 |
| 1578911293 | Christina Marie Van Hilst | Nurse Practitioner | 1001 Sushruta Dr, Martinsburg, WV 25401 | 2016-06-03 |
| 1578926549 | Barathy Radhakrishnan | Speech-Language Pathologist | 401 Queen Street, Berkeley County Board of Education, Martinsburg, WV 25401 | 2016-03-29 |
| 1972985638 | Wellco Dme LLC | Durable Medical Equipment & Medical Supplies | 107 Tavern Rd, Martinsburg, WV 25401 | 2015-06-18 |
| 1457731960 | Patrick Hamilton Noland | Dentist | 1003 Sushruta Dr., Martinsburg, WV 25401 | 2015-06-01 |
| 1801296330 | Terry Harden | Massage Therapist | 601 South Raliegh St., Martinsburg, WV 25401 | 2014-09-03 |
| Find all providers in zip 25401 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609000900 | Raymond L Eifel | Physician Assistant | 2000 Foundation Way Ste 3400, Martinsburg, WV 25401-9583 | 2009-05-14 |
| 1043239726 | Mark Alan Brown | Physician Assistant | 121 Fawn Haven Ct, Martinsburg, WV 25401-5285 | 2006-07-19 |
| 1306890884 | Kevin R Garneau | Physician Assistant | 2500 Hosptial Drive, Martinsburg, WV 25401 | 2006-05-20 |
| 1407100860 | James Allen Payne | Physician Assistant | 101 Marcley Dr, Martinsburg, WV 25401-2977 | 2012-11-06 |
| 1528359825 | Candice Marie Moreland | Physician Assistant | 101 Marcley Dr, Martinsburg, WV 25401-2977 | 2011-04-21 |
| 1366681652 | Heather Reay Jewell | Physician Assistant | 101 Marcley Dr, Martinsburg, WV 25401-2977 | 2009-02-11 |
| 1275717449 | Tuyet Mai Dang Houston | Physician Assistant | 101 Marcley Dr, Martinsburg, WV 25401-2977 | 2007-12-24 |
| 1851300636 | Samuel Amaro | Physician Assistant | 510 Butler Ave, Martinsburg, WV 25401-9990 | 2006-08-07 |
| 1609824085 | Mark Joseph Contrael | Physician Assistant | 510 Butler Ave, Martinsburg, WV 25405-9990 | 2006-05-05 |
| 1598745432 | Michael Joseph Tate | Physician Assistant | 510 Butler Ave, Martinsburg, WV 25405-9990 | 2006-01-18 |
| Find all providers in MARTINSBURG | ||||
| City | MARTINSBURG |
| Zip Code | 25401 |
Please comment or provide details below to improve the information on MRS. DENISE MARIE PETTIT.
| 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.