JACQUELINE PETTAWAY CRNP
NPI 1841695954
Nurse Practitioner - Family in Mobile, AL

Q: What is Jacqueline Pettaway's NPI number?

The NPI number for Jacqueline Pettaway is 1841695954. It was assigned to this individual provider in the NPPES registry on October 31, 2014.

Q: What is Jacqueline Pettaway's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Active since October 31, 2014PECOS Enrolled

1601 CENTER ST, MOBILE, AL 36604(251) 410-5437(251) 434-3876 Get Directions Write a Review

NPPES record last updated: March 2, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Jacqueline Pettaway Crnp NPPES

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

JACQUELINE PETTAWAY CRNP (NPI 1841695954) is an individual family provider in Mobile, Alabama, licensed in Alabama (1-076204) and active in the NPI registry since October 2014. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1841695954

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameJACQUELINE PETTAWAYCredential: CRNP

Location Address1601 CENTER STMobile, AL 36604-1541

Mailing AddressPo Box 40480Mobile, AL 36640-0480 · (251) 434-3626 · Fax (251) 445-2464

Phone(251) 410-5437

Fax(251) 434-3876

Sole ProprietorNo

Enumeration DateOctober 31, 2014

Last NPPES UpdateMarch 2, 2021

NPPES CertifiedMarch 2, 2021

✔ NPI 1841695954 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in AL · 1-076204

1601 CENTER ST, Mobile, AL 36604

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health 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 (PECOS)

Jacqueline Pettaway Crnp 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 36604 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

$81.90 typical visit price

range $52.65 – $161.63

Typical copayment $20.47 (range $13.16 – $40.40)

Most-billed visit code 99203

Established Patient

$93.72 typical visit price

range $16.56 – $131.65

Typical copayment $23.43 (range $4.14 – $32.91)

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 20

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

MRS. JENNIFER GALLAGHER WILLIAMS CRNP

Nurse Practitioner (Pediatrics)

1601 CENTER ST, STE 1S
MOBILE, AL 36604

Mobile County (251) 410-5437

LADONNA M. CREWS MD

Pediatrics

1601 CENTER ST, STE 1N
MOBILE, AL 36604

Mobile County (251) 410-5437

USA HEALTH PHYSICIAN BILLING SERVICES LLC

Obstetrics & Gynecology