Carolyn Barnwell Petrey, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

026914 Issued in GA

Practice address

696 Grayson Hwy
Family Practice Clinic PC
Lawrenceville, GA 30046-6372

Phone

(770) 963-0927

Fax

(770) 963-9772

NPI assigned

Aug 24, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283126400000",
    "number": "1003923145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "696 GRAYSON HIGHWAY",
            "address_2": "FAMILY PRACTICE CLINIC PC",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300466372",
            "telephone_number": "770-963-0927",
            "fax_number": "770-963-9772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "696 GRAYSON HWY",
            "address_2": "FAMILY PRACTICE CLINIC PC",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300466372",
            "telephone_number": "770-963-0927",
            "fax_number": "770-963-9772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETREY",
        "first_name": "CAROLYN",
        "middle_name": "BARNWELL",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-24",
        "last_updated": "2010-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "026914",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00302222A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marsh Peterson
• Seth William Peterson
• Loritz Petit-Homme
• Richard G Petit, P.A.
• Mary Petner, LMSW
• Kathryn Ann Petterson, PH.D.
• Faresa N Petti Daniel, COTA
• Donald Minh Pham, M.D.
• Hongvien Pham, PHARM D
• Jamila-Duyen P Pham, MD

• Family Medicine Physician in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.