Jacita Booker Petway, PSYD in Huntersville, NC - Medicare Clinical Psychologist Provider

Jacita Booker Petway, PSYD is a medicare enrolled "Psychologist" provider in Huntersville, North Carolina. She graduated from medical school in 2007 and has 19 years of diverse experience with area of expertise as Clinical Psychologist. She is a member of the group practice Novant Health Medical Group, Llc and her current practice location is 13815 Professional Center Dr Ste 100, Huntersville, North Carolina. You can reach out to her office (for appointments etc.) via phone at (704) 384-1320.

Jacita Booker Petway is licensed to practice in North Carolina (license number 7089) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1477796316.

Contact Information

	Jacita Booker Petway, PSYD
	13815 Professional Center Dr Ste 100, Huntersville, NC 28078-7951
	(704) 384-1320
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Jacita Booker Petway
Gender	Female
Speciality	Clinical Psychologist
Experience	19 Years
Location	13815 Professional Center Dr Ste 100, Huntersville, North Carolina
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Jacita Booker Petway graduated from medical school in 2007

NPI Data:

NPI Number: 1477796316
Provider Enumeration Date: 04/08/2009
Last Update Date: 06/09/2026

Medicare PECOS Information:

PECOS PAC ID: 7810159027
Enrollment ID: I20121019000685

Medical Identifiers

Medical identifiers for Jacita Booker Petway such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1477796316	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103T00000X	Psychologist	7089 (North Carolina)	Primary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Novant Health Medical Group, Llc	1153234893	2401

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. Jacita Booker Petway allows following entities to bill medicare on her behalf.

Entity Name	Novant Health Medical Group, Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1366409492 PECOS PAC ID: 1153234893 Enrollment ID: O20031121000692

Entity Name	Daymark Recovery Services Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1558329243 PECOS PAC ID: 0547233975 Enrollment ID: O20040814000213

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. Jacita Booker Petway 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
Jacita Booker Petway, PSYD 284 Executive Park Dr Ste 100, Concord, NC 28025-1833 Ph: (704) 939-1100	Jacita Booker Petway, PSYD 13815 Professional Center Dr Ste 100, Huntersville, NC 28078-7951 Ph: (704) 384-1320

Reviews and Comments

Psychologist in Huntersville, NC

Kristy Smith Johnson, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 11330 Vanstory Dr Ste 109, Huntersville, NC 28078 Phone: 304-444-8735 Fax: 980-422-0240
Allison Marie Rollinson, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 9820 Northcross Center Ct Ste 73, Huntersville, NC 28078 Phone: 704-997-9566
Jennifer E Sipp, M.A., LPA, HSP-PA Psychologist Medicare: Not Enrolled in Medicare Practice Location: 9835 Northcross Center Ct, Suite B, Huntersville, NC 28078 Phone: 704-896-8688 Fax: 704-353-7029
Jenine Saekow, PSY.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 15059 Northgreen Dr, Huntersville, NC 28078 Phone: 650-434-2955
Karen Elizabeth Butler, LPA Psychologist Medicare: Not Enrolled in Medicare Practice Location: 11913 Henderson Hill Rd, Huntersville, NC 28078 Phone: 704-604-2713
Erin Shunkesha Jackson, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 11330 Vanstory Dr Ste 109f, Huntersville, NC 28078 Phone: 980-705-4122

Jacita Booker Petway, PSYD - Medicare Psychologist in Huntersville, NC