Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Gregory J Pettaway II, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1851701841

Gregory J Pettaway II, MD is an Emergency Medicine in South Bend, Indiana. Graduated from University of Alabama School of Medicine in 2014, 12 years ago. Practices with Island Medical Alabama LLC, a 24-clinician group and accepts Medicare assignment. Licensed in Indiana.

Years since qualifying
12
Trained at
University of Alabama School of Medicine
Licensed in
IN
In the registry since
2014
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

615 N Michigan St
South Bend, IN 46601-1033
Phone: (574) 647-1000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence 01078046A (IN)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1851701841
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 30, 2014
Last updated in NPPESJuly 21, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyEMERGENCY MEDICINE
Medical schoolUNIVERSITY OF ALABAMA SCHOOL OF MEDICINE
Graduated 2014 (12 years in practice)
Group practice Island Medical Alabama Llc — 24 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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