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ELVY PETTIT JR. P.A.
NPI 1972775427
Physician Assistant - Medical in Winston Salem, NC

Active since March 25, 2008PECOS Enrolled
3080 TRENWEST DR, THE SALEM CENTER, WINSTON SALEM, NC 27103(336) 768-0496(336) 768-0498 Get Directions Write a Review

NPPES record last updated: March 25, 2008. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Elvy Pettit Jr. P.a. NPPES

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

ELVY PETTIT JR. P.A. (NPI 1972775427) is an individual medical provider in Winston Salem, North Carolina, licensed in North Carolina (101961) and active in the NPI registry since March 2008. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1972775427
Entity TypeIndividualMale
Primary Taxonomy363AM0700X
Provider Legal NameELVY PETTIT JR.Credential: P.A.
Location Address3080 TRENWEST DR, THE SALEM CENTERWinston Salem, NC 27103-3208
Mailing Address3080 Trenwest Dr, The Salem CenterWinston Salem, NC 27103-3208 · (336) 768-0496 · Fax (336) 768-0498
Phone(336) 768-0496
Fax(336) 768-0498
Sole ProprietorNo
Enumeration DateMarch 25, 2008
✔ NPI 1972775427 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in NC · 101961
3080 TRENWEST DR, Winston Salem, NC 27103
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Other Identifiers 1

Medicare UPINC81057

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Elvy Pettit Jr. P.a. 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.

Other Providers at the Same Location NPPES 2

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

DR. JAIME E TRUJILLO MD
Internal Medicine
3080 TRENWEST DR
WINSTON SALEM, NC 27103
Forsyth County (336) 768-0496
ELISABETH MARIE MOTSINGER P.A.
Physician Assistant (Medical)
3080 TRENWEST DR, THE SALEM CENTER
WINSTON SALEM, NC 27103
Forsyth County (336) 768-0496

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 Elvy Pettit's NPI number?

The NPI number for Elvy Pettit is 1972775427. It was assigned to this individual provider in the NPPES registry on March 25, 2008.

Where is Elvy Pettit located?

Elvy Pettit practices at 3080 Trenwest Dr The Salem Center, Winston Salem, NC 27103. The listed phone number is (336) 768-0496.

What is Elvy Pettit's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Elvy Pettit enrolled in Medicare?

Yes. Elvy Pettit is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Elvy Pettit was last updated on March 25, 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.