DR. ZANDRA RENEE PETWAY MD NPI 1265447619

NPI Information

NPI: 1265447619
Provider Name: DR. ZANDRA RENEE PETWAY, MD
Classification: General Practice - 208D00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
395 WALLACE RD STE B307
NASHVILLE, TN
ZIP 37211
Phone: (615) 884-0215
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DR. Zandra Renee Petway, MD is a general practice in Nashville, TN with 29 years of experience. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee DR. Zandra Renee Petway, MD NPI is 1265447619. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: MEHARRY MEDICAL COLLEGE SCHOOL OF MEDICINE
Graduation Year:1995

The provider's business location address is:

395 WALLACE RD STE B307
NASHVILLE, TN
ZIP 37211-881
Phone: (615) 884-0215
Fax: (615) 884-0219

The NPI 1265447619 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/31/2006 and was last updated on 7/8/2007.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208D00000X	General Practice		27699	TENNESSEE	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	3802977	MEDICAID	TENNESSEE
2	G28853	MEDICARE UPIN	TENNESSEE
3	3802977	MEDICARE ID-TYPE UNSPECIFIED	TENNESSEE

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

NPI Synchronization or Removal

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