WILLIAM H PETTIBON PHD PA
NPI 1336314707
Psychologist in Sarasota, FL

Active since April 28, 2008
3800 S TAMIAMI TRL UNIT 210, SARASOTA, FL 34239(941) 366-1693(941) 922-7574 Get Directions Write a Review

NPPES record last updated: April 28, 2008. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About William H Pettibon Phd Pa NPPES

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

WILLIAM H PETTIBON PHD PA (NPI 1336314707) is a healthcare organization registered as a psychologist in Sarasota, Florida and active in the NPI registry since April 2008. The organization lists William Harry Pettibon, Clinical Psychologist/owner, as its authorized official.

NPPES Registry Identity

NPI1336314707
Entity TypeOrganization
Primary Taxonomy103T00000X
Legal Business NameWILLIAM H PETTIBON PHD PA
Location Address3800 S TAMIAMI TRL UNIT 210Sarasota, FL 34239-6909
Mailing Address6521 Keystone DrSarasota, FL 34231-7133 · (941) 922-7574 · Fax (941) 922-7574
Fax(941) 922-7574
Organization SubpartNo
Authorized OfficialWilliam Harry PettibonClinical Psychologist/owner · (941) 366-1693
Enumeration DateApril 28, 2008
✔ NPI 1336314707 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License✔ Licensed in FL · PY6096
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
3800 S TAMIAMI TRL UNIT 210, Sarasota, FL 34239

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

William H Pettibon Phd Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

4

Medicare enrollment records show 4 clinicians reassign Medicare billing to William H Pettibon Phd PA, which bills Medicare for the services they deliver. Of these, 4 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (4)

Clinical Psychologist
NPI 1629267877
3800 S TAMIAMI TRL UNIT 210
Sarasota, FL 34239
(941) 366-1693
✔ PECOS✔ Accepts Medicare0.1 mi
Clinical Social Worker
NPI 1437454212
3800 S TAMIAMI TRL UNIT 210
Sarasota, FL 34239
(941) 525-0157
✔ PECOS✔ Accepts Medicare0.1 mi
Clinical Psychologist
NPI 1447425137
3800 S TAMIAMI TRL UNIT 210
Sarasota, FL 34239
(941) 366-1693
✔ PECOS✔ Accepts Medicare0.1 mi
Clinical Psychologist
NPI 1043294325
2650 BAHIA VISTA ST STE 201
Sarasota, FL 34239
(941) 685-6098
✔ PECOS✔ Accepts Medicare1.8 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 William H Pettibon Phd PA's NPI number?

The NPI number for William H Pettibon Phd PA is 1336314707. It was assigned to this organization in the NPPES registry on April 28, 2008.

Where is William H Pettibon Phd PA located?

William H Pettibon Phd PA is located at 3800 S Tamiami Trl Unit 210, Sarasota, FL 34239. The listed phone number is (941) 366-1693.

What is William H Pettibon Phd PA's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is William H Pettibon Phd PA enrolled in Medicare?

Yes. William H Pettibon Phd PA is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through William H Pettibon Phd PA?

According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians in 2 Medicare specialties reassign their Medicare billing to William H Pettibon Phd PA. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Clinical Psychologist (3) and Clinical Social Worker (1). Of these, 4 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does William H Pettibon Phd PA accept?

Health plans from Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list William H Pettibon Phd PA as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for William H Pettibon Phd PA was last updated on April 28, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.