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

Mrs. Amy Dietzen Petticrew, PA-C

Individual provider Physician Assistant · NPI 1801287610

Mrs. Amy Dietzen Petticrew, PA-C is a Physician Assistant in Charlotte, North Carolina. Graduated from Brody School of Medicine at East Carolina University in 2014, 12 years ago. Practices with Novant Health Medical Group, LLC, a 2,410-clinician group, accepts Medicare assignment and offers telehealth. Licensed in North Carolina.

Years since qualifying
12
Trained at
Brody School of Medicine at East Carolina University
Licensed in
NC
In the registry since
2015
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

6324 Fairview Rd Ste 201
Charlotte, NC 28210-3271
Phone: (704) 384-0588
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 0010-05569 (NC)

Record details

NPI number1801287610
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedFebruary 16, 2015
Last updated in NPPESApril 26, 2023
Certification dateApril 26, 2023

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolBRODY SCHOOL OF MEDICINE AT EAST CAROLINA UNIVERSITY
Graduated 2014 (12 years in practice)
Group practice Novant Health Medical Group, Llc — 2410 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations4 on file with Medicare

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