Active NPI
Danielle Petrie
- Pharmacist
- Greenville, SC
National Provider Identifier
1013384908
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 23925
- Practice address
- 620 Congaree Rd
Suite F
Greenville, SC 29607-3502 - Phone
- (864) 241-0477
- NPI assigned
- Aug 26, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 23925 | MA | Primary |
| Pharmacist | 183500000X | 13934 | SC |
Addresses
Primary practice location
620 Congaree Rd
Suite F
Greenville, SC 29607-3502
Mailing address
4 Heather Stone CT
Simpsonville, SC 29680-7140
Phone (774) 254-3001
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23925 | MA | MD | Pharmacist |
| 13934 | SC | MD | Radiation Oncology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1440547200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1475712000000",
"number": "1013384908",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4 HEATHER STONE CT",
"city": "SIMPSONVILLE",
"state": "SC",
"postal_code": "296807140",
"telephone_number": "774-254-3001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "620 CONGAREE RD",
"address_2": "SUITE F",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296073502",
"telephone_number": "864-241-0477"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETRIE",
"first_name": "DANIELLE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-08-26",
"last_updated": "2016-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MA",
"license": "23925",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "SC",
"license": "13934",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greenville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.