Kenneth Lee Pettit (NPI# 1447296298, PAC ID# 4284616616) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OSTEOPATHIC MANIPULATIVE MEDICINE.
| Nation Provider ID (NPI) | 1447296298 |
| PAC ID by PECOS | 4284616616 |
| Professional Enrollment ID | I20040609000852 |
| Full Name | Kenneth Lee Pettit |
| Address |
16515 S 40th St Suite 139 Phoenix AZ 85048-0560 |
| Gender | M |
| Credential | DO |
| Medical School | COLLEGE OF OSTEO OF THE PACIFIC |
| Graduation Year | 1997 |
| Primary Specialty | OSTEOPATHIC MANIPULATIVE MEDICINE |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 030121 | MOUNTAIN VISTA MEDICAL CENTER, LP |
| 030119 | MERCY GILBERT MEDICAL CENTER |
| 030110 | ABRAZO WEST CAMPUS |
| Address | Phone | Organization |
|---|---|---|
| 16515 S 40th St, Suite 139, Phoenix, AZ 85048-0560 | ||
| 821 N 5th Ave, Phoenix, AZ 85003-1315 | 6026807722 | ARIZONA BLEEDING DISORDERS HEALTH AND WELLNESS CENTER |
| Street Address |
16515 S 40TH ST SUITE 139 |
| City | PHOENIX |
| State | AZ |
| Zip | 85048-0560 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Michael J De Rubeis | Optometry | 16515 S 40th St, Suite 111, Phoenix, AZ 85048-0559 | |
| John S Mettham | Chiropractic | 16515 S 40th St, Suite 129, Phoenix, AZ 85048-0560 | |
| Shari R Webster | Chiropractic | 16515 S 40th St, Suite 103, Phoenix, AZ 85048-0559 | |
| Jennifer R Winton | Chiropractic | 16515 S 40th St, Suite 131, Phoenix, AZ 85048-0560 | |
| Daniel M Pacheco | Internal Medicine | 16515 S 40th St, Suite 119, Phoenix, AZ 85048-0559 | |
| Michael Akerson | Chiropractic | 16515 S 40th St, Suite 133, Phoenix, AZ 85048-0560 | |
| Ira L Snider | Family Medicine | Phoenician Medical Center Inc | 16515 S 40th St, Suite 139, Phoenix, AZ 85048-0560 |
| Julia Annette Kieffer | Nurse Practitioner | Phoenician Medical Center Inc | 16515 S 40th St, Suite 139, Phoenix, AZ 85048-0560 |
| Heather D Akerson | Nurse Practitioner | 16515 S 40th St, Suite 133, Phoenix, AZ 85048-0560 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Carrie C Goodrum | Nurse Practitioner | Take Care Health Arizona PC | 3960 E Chandler Blvd, Phoenix, AZ 85048-0300 |
| Vicky L Davis | Nurse Practitioner | Take Care Health Arizona PC | 3960 E Chandler Blvd, Phoenix, AZ 85048-0300 |
| Sarah Locke | Nurse Practitioner | Take Care Health Arizona PC | 3960 E Chandler Blvd, Phoenix, AZ 85048-0300 |
| Ansen D Blair | Physician Assistant | Take Care Health Arizona PC | 3960 E Chandler Blvd, Phoenix, AZ 85048-0300 |
| Carol D Moffett | Nurse Practitioner | Take Care Health Arizona PC | 3960 E Chandler Blvd, Phoenix, AZ 85048-0300 |
| Murray S Pratt | Optometry | Pratt Vision LLC | 3961 E Chandler Blvd, 106 Lifetime Eye Care, Phoenix, AZ 85048-0303 |
| Anthony Kash Sullenger | Optometry | Pratt Vision LLC | 3961 E Chandler Blvd, 106 Lifetime Eye Care, Phoenix, AZ 85048-0303 |
| Kelly Desimone | Optometry | 15725 S 46th St, Suite 112, Phoenix, AZ 85048-0443 | |
| Janet L Mullins | Family Medicine | Kachina Family Practice Pa | 16611 S 40th St, Suite 120, Phoenix, AZ 85048-0562 |
| Jaron J Fischbeck | Family Medicine | Kachina Family Practice Pa | 16611 S 40th St, Suite 120, Phoenix, AZ 85048-0562 |
| Find all physicians in zip 85048 | |||
| City | PHOENIX |
| Zip Code | 85048 |
| Specialty | OSTEOPATHIC MANIPULATIVE MEDICINE |
| City + Specialty | PHOENIX + OSTEOPATHIC MANIPULATIVE MEDICINE |
Please comment or provide details below to improve the information on Kenneth Lee Pettit.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.