1. Home
  2. Directory
  3. Arkansas
  4. Conway
  5. Dietitian Registered
  6. NPI Profile

MRS. MARY JANE PETTIT RD LD
NPI 1801054747
Dietitian, Registered in Conway, AR

Active since May 28, 2008Accepts Medicare Assignment
2200 BRUCE ST. STE 101, CONWAY, AR 72034(501) 470-7457(501) 504-2105 Get Directions Write a Review

NPPES record last updated: September 13, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mrs. Mary Jane Pettit Rd Ld NPPES

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

MRS. MARY JANE PETTIT RD LD (NPI 1801054747) is an individual dietitian, registered in Conway, Arkansas, licensed in Arkansas (807715) and active in the NPI registry since May 2008. She is a graduate of Other (1993).

NPPES Registry Identity

NPI1801054747
Entity TypeIndividualFemale
Primary Taxonomy133V00000X
Provider Legal NameMRS. MARY JANE PETTITCredential: RD LD
Location Address2200 BRUCE ST. STE 101Conway, AR 72034
Mailing Address2200 Bruce St. Ste 101Conway, AR 72034 · (501) 470-7457 · Fax (501) 504-2105
Phone(501) 470-7457
Fax(501) 504-2105
Sole ProprietorYes
Medical School CMSOtherGraduated 1993
Enumeration DateMay 28, 2008
Last NPPES UpdateSeptember 13, 2022
NPPES CertifiedSeptember 12, 2022
✔ NPI 1801054747 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDietitian, RegisteredDietary & Nutritional Service Providers
Taxonomy Code133V00000X
License✔ Licensed in AR · 807715
Definition
A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.
2200 BRUCE ST. STE 101, Conway, AR 72034
Open in Google Maps ↗

Other Identifiers 1

Medicaid101615105AR

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mrs. Mary Jane Pettit Rd Ld is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7214085687
PECOS Enrollment IDI20090423000609

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 72034 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $51.36 – $157.74
Typical copayment $0.00 (range $12.84 – $39.43)
Most-billed visit code NA
Established Patient
$91.63 typical visit price
range $16.16 – $128.77
Typical copayment $22.90 (range $4.04 – $32.19)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

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

MISS AMBER LYNN LINGLE GOFF M.S CCC-SLP
Speech-Language Pathologist
2200 BRUCE ST. STE 101
CONWAY, AR 72034
Faulkner County (501) 470-7457

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 Mary Pettit's NPI number?

The NPI number for Mary Pettit is 1801054747. It was assigned to this individual provider in the NPPES registry on May 28, 2008.

Where is Mary Pettit located?

Mary Pettit practices at 2200 Bruce St. Ste 101, Conway, AR 72034. The listed phone number is (501) 470-7457.

What is Mary Pettit's specialty?

The primary specialty registered for this NPI is Dietitian, Registered with taxonomy code 133V00000X.

Is Mary Pettit enrolled in Medicare?

Yes. Mary Pettit is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Mary Pettit accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health and Ambetter from Superior HealthPlan and 5 other insurers list Mary Pettit 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 Mary Pettit was last updated on September 13, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.