EMILY BROOKE PETTIS (CRNP) – Adult Health Nurse Practitioner, NPI 1811390396

EMILY BROOKE PETTIS (CRNP) is a healthcare provider. based in Dothan, Alabama. specializing in NURSE PRACTITIONER. They hold the professional credentials CRNP. They hold a License No. AG0114029 (AL). The NPI Number for EMILY BROOKE PETTIS (CRNP) is 1811390396

Main info

Female
Sole Proprietor
13 Years Of Experience
Accepts Medicare Assignment
Name
EMILY BROOKE PETTIS (CRNP)
NPI
1811390396
Phone
(334) 794-1148
Address
1118 ROSS CLARK CIR STE 100
Enumeration Date
29 September 2014
Last Update Date
30 September 2014

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3347941148
Graduation Year
2013 (13 years ago)
PAC ID
2961750187
Group Practice PAC ID
7416848247
Professional Enrollment ID
I20180803002825
Address ID
AL363013023DO1118XCIRX401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience36
Completeness75
Years active:11State licenses:1Digital endpointsOther names

5,653 NURSE PRACTITIONER in AL

Provider Addresses for EMILY BROOKE PETTIS (CRNP)

  • 1118 ROSS CLARK CIR STE 100

    DOTHAN, AL 363013023

    Phone: (334) 794-1148

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 143 Open Payments records for all available years, with a total value of $2,715.

Total Amount is formed as General ($2,715) + Research ($0) + Ownership ($0) = $2,715.

Last reported payment date: 2024-12-11 • Largest payer in this snapshot: Amgen Inc. ($579).

Total Amount

$2,715

General + Research + Ownership

Payments

143

Total payment records

General Amount

$2,715

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-11

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2018-08-03

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20180803002825INurse PractitionerALTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 36301)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7416848247View full group profile
NameSpecialtyState
Nurse PractitionerAL
Nurse PractitionerAL
Internal MedicineAL
Nurse PractitionerAL
R H E U M A T O L O G YAL
Internal MedicineVA
Nurse PractitionerAL
Nurse PractitionerAL
Nurse PractitionerAL
Nurse PractitionerAL

Reviews

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Frequently asked questions

Can I use this page to confirm EMILY BROOKE PETTIS (CRNP)'s NPI?
Yes. EMILY BROOKE PETTIS (CRNP) is listed with NPI 1811390396 in the public NPI dataset.
Does CMS list EMILY BROOKE PETTIS (CRNP) as active?
Yes — EMILY BROOKE PETTIS (CRNP) is active in the NPI listing used on this page.
What taxonomy line describes EMILY BROOKE PETTIS (CRNP)?
For research purposes, treat EMILY BROOKE PETTIS (CRNP) as Adult Health Nurse Practitioner in this dataset. Clinical services aligned with this taxonomy classification.
Does EMILY BROOKE PETTIS (CRNP) list a practice location?
Patients near Dothan, Alabama may find EMILY BROOKE PETTIS (CRNP) in results; validate coverage separately.
Is the information about EMILY BROOKE PETTIS (CRNP) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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