DR. COLTON RYAN PETTY MD - NPI 1629743083 - Student in an Organized Health Care Education/Training Program in Knoxville, TN

Q: What is Colton Petty's NPI number?

The NPI number for Colton Petty is 1629743083. It was assigned to this individual provider in the NPPES registry on August 9, 2021.

Q: What is Colton Petty's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Colton Petty was last updated on March 26, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Dr. Colton Ryan Petty Md NPPES

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

DR. COLTON RYAN PETTY MD (NPI 1629743083) is an individual student in an organized health care education/training program in Knoxville, Tennessee and active in the NPI registry since August 2021. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1629743083

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameDR. COLTON RYAN PETTYCredential: MD

Location Address1924 ALCOA HWY # U-107Knoxville, TN 37920-1511

Mailing Address910 Madison Ave Ste 1002Memphis, TN 38103-3487 · (901) 448-5529

Phone(901) 448-5529

Sole ProprietorNo

Enumeration DateAugust 9, 2021

Last NPPES UpdateMarch 26, 2024

NPPES CertifiedMarch 26, 2024

✔ NPI 1629743083 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Also ListedGeneral PracticeTaxonomy 208D00000X · License 68958 (TN)

1924 ALCOA HWY # U-107, Knoxville, TN 37920

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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)

Dr. Colton Ryan Petty Md 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.