JEREMY PETTY FNP-C
NPI 1942515812
Nurse Practitioner - Family in Columbus, GA
Active since August 16, 2010
About Jeremy Petty Fnp-c NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JEREMY PETTY FNP-C (NPI 1942515812) is an individual family provider in Columbus, Georgia, licensed in Georgia (APRN-NP175210) and active in the NPI registry since August 2010. He maintains a secondary practice location in Columbus.
NPPES Registry Identity
NPI1942515812
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NameJEREMY PETTYCredential: FNP-C
Location Address4561 RIVER RD STE AColumbus, GA 31904-5828
Mailing AddressPo Box 740015Atlanta, GA 30374-0015 · (312) 733-9730
Phone(706) 478-5717
Fax(706) 229-4883
Sole ProprietorNo
Enumeration DateAugust 16, 2010
Last NPPES UpdateNovember 4, 2025
NPPES CertifiedNovember 4, 2025
✔ NPI 1942515812 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 GA · APRN-NP175210
4561 RIVER RD STE A, Columbus, GA 31904
Secondary Practice Location 1
Location 12737 Warm Springs RdColumbus, GA 31904-6859 · Phone (706) 653-2255 · Fax (706) 653-2329
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.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1942515812, enumerated as an "individual" on August 16, 2010.
The provider is located at 4561 RIVER RD STE A COLUMBUS, GA 31904 and the phone number is (706) 478-5717.
Nurse Practitioner with taxonomy code 363LF0000X and a focus in Family.
