PATRICIA ANN PETTIS APRN
NPI 1104582097
Pediatrics - Adolescent Medicine in Newington, NH

Q: What is Patricia Pettis's NPI number?

The NPI number for Patricia Pettis is 1104582097. It was assigned to this individual provider in the NPPES registry on November 15, 2021.

Q: What is Patricia Pettis's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Adolescent Medicine, with taxonomy code 2080A0000X.

Q: When was this NPI record last updated?

The NPPES record for Patricia Pettis was last updated on November 15, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since November 15, 2021PECOS Enrolled

100 SHATTUCK WAY STE 100, NEWINGTON, NH 03801(603) 431-6677(603) 610-2232 Get Directions Write a Review

NPPES record last updated: November 15, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Patricia Ann Pettis Aprn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PATRICIA ANN PETTIS APRN (NPI 1104582097) is an individual adolescent medicine provider in Newington, New Hampshire, licensed in New Hampshire (031898-23) and active in the NPI registry since November 2021. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1104582097

Entity TypeIndividualFemale

Primary Taxonomy2080A0000X

Provider Legal NamePATRICIA ANN PETTISCredential: APRN

Location Address100 SHATTUCK WAY STE 100Newington, NH 03801-8007

Mailing Address100 Shattuck Way Ste 100Newington, NH 03801-8007 · (603) 431-6677 · Fax (603) 610-2232

Phone(603) 431-6677

Fax(603) 610-2232

Sole ProprietorNo

Enumeration DateNovember 15, 2021

NPPES CertifiedNovember 15, 2021

✔ NPI 1104582097 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Adolescent MedicineAllopathic & Osteopathic Physicians

Taxonomy Code2080A0000X

License✔ Licensed in NH · 031898-23

Definition

A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.

100 SHATTUCK WAY STE 100, Newington, NH 03801

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Patricia Ann Pettis Aprn is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NICOLE S REMBISZ APRN

Nurse Practitioner (Primary Care)

100 SHATTUCK WAY STE 100
NEWINGTON, NH 03801

Rockingham County (603) 431-6677

JENNIFER LYNN FLOOD APRN

Nurse Practitioner (Family)

100 SHATTUCK WAY STE 100
NEWINGTON, NH 03801

Rockingham County (603) 431-6677

JESSICA ROUNDY FNP-BC

Nurse Practitioner (Family)

100 SHATTUCK WAY STE 100
NEWINGTON, NH 03801

Rockingham County (603) 431-6677

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Patricia Pettis's NPI number?

The NPI number for Patricia Pettis is 1104582097. It was assigned to this individual provider in the NPPES registry on November 15, 2021.

Where is Patricia Pettis located?

Patricia Pettis practices at 100 Shattuck Way Ste 100, Newington, NH 03801. The listed phone number is (603) 431-6677.

What is Patricia Pettis's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Adolescent Medicine, with taxonomy code 2080A0000X.

Is Patricia Pettis enrolled in Medicare?

Yes. Patricia Pettis is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Patricia Pettis was last updated on November 15, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.