Mrs Mary Jane Pettit, RD LD in Conway, AR - Medicare Dietitian, Registered Provider

Mrs Mary Jane Pettit, RD LD is a medicare enrolled "Dietitian, Registered" provider in Conway, Arkansas. Her current practice location is 2200 Bruce St. Ste 101, Conway, Arkansas. You can reach out to her office (for appointments etc.) via phone at (501) 470-7457.

Mrs Mary Jane Pettit is licensed to practice in Arkansas (license number 807715) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1801054747.

Contact Information

	Mrs Mary Jane Pettit, RD LD
	2200 Bruce St. Ste 101, Conway, AR 72034
	(501) 470-7457
	(501) 504-2105

Map and Direction

Healthcare Provider's Profile

Full Name	Mrs Mary Jane Pettit
Gender	Female
Speciality	Dietitian, Registered
Location	2200 Bruce St. Ste 101, Conway, Arkansas
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1801054747
Provider Enumeration Date: 05/28/2008
Last Update Date: 09/13/2022

Medicare PECOS Information:

PECOS PAC ID: 7214085687
Enrollment ID: I20090423000609

Medical Identifiers

Medical identifiers for Mrs Mary Jane Pettit such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1801054747	NPI	-	NPPES
101615105	Medicaid	AR

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
133V00000X	Dietitian, Registered	807715 (Arkansas)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mrs Mary Jane Pettit allows following entities to bill medicare on her behalf.

Provider Name	University Of Central Arkansas
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1912543240 PECOS PAC ID: 0042612244 Enrollment ID: O20210712000255

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Mary Jane Pettit is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mrs Mary Jane Pettit, RD LD 2200 Bruce St. Ste 101, Conway, AR 72034 Ph: (501) 470-7457	Mrs Mary Jane Pettit, RD LD 2200 Bruce St. Ste 101, Conway, AR 72034 Ph: (501) 470-7457

Reviews and Comments

Dietitian, Registered in Conway, AR

Janet A Dance, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 2125 Desha Dr, Conway, AR 72034 Phone: 501-269-7213
Dr. Alicia Landry, PHD, RDN, LDN Dietitian Medicare: Not Enrolled in Medicare Practice Location: 201 Donaghey Ave,, Mcalister 100, Conway, AR 72035 Phone: 501-852-0230
Chelsea Dawn Lary, RD Dietitian Medicare: Medicare Enrolled Practice Location: 2115 Spring Valley Dr, Conway, AR 72034 Phone: 430-200-6761
Whitney Marie Holland, MS, RDN Dietitian Medicare: Not Enrolled in Medicare Practice Location: 3475 Malvern Hill Rd, Conway, AR 72032 Phone: 501-259-1149
Dr. Jerry Mayo, PHD, RDN Dietitian Medicare: Not Enrolled in Medicare Practice Location: 1060 Applewood Dr, Conway, AR 72034 Phone: 501-733-6575
Mrs. Candace Lacy Turner, MS, RDN, LD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 1965 Bellingrath Gdns, Conway, AR 72034 Phone: 501-499-5760
Jolie Jackson, MS, RDN, LD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 2302 College Ave, Conway, AR 72034 Phone: 501-513-5248

Mrs Mary Jane Pettit, RD LD - Medicare Dietitian in Conway, AR