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DR. KENNETH A PETTINE M.D. NPI 1720069198


NPI Information

NPI: 1720069198
Provider Name: DR. KENNETH A PETTINE, M.D.
Classification: Orthopaedic Surgery - 207XS0117X
Entity Type: Individual

Specialization: Orthopaedic Surgery of the Spine

Address:
4795 LARIMER PARKWAY
JOHNSTOWN, CO
ZIP 80534
Phone: (970) 669-8881
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DR. Kenneth A Pettine, M.D. is an orthopaedic surgery of the spine orthopaedic surgery in Johnstown, CO. The provider is recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic surgeons of the spine deal with the evaluation and nonoperative and operative treatment of the full spectrum of primary spinal disorders including trauma, degenerative, deformity, tumor, and reconstructive. DR. Kenneth A Pettine, M.D. NPI is 1720069198. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

4795 LARIMER PARKWAY
JOHNSTOWN, CO
ZIP 80534
Phone: (970) 669-8881
Fax: (970) 669-4200

The enumeration date for this NPI number is 11/10/2005 and was last updated on 3/23/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207XS0117XOrthopaedic SurgeryOrthopaedic Surgery of the Spine29524COLORADOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1B92648MEDICARE UPINCOLORADO
2CB7718MEDICARE PINCOLORADO
301295245MEDICAIDCOLORADO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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