Individual provider Active NPI

Angela Dawn Petry, N.P.-C

  • Family Nurse Practitioner
  • Winchester, VA
National Provider Identifier
1023286010
Registry record updated Jul 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024178599 Issued in VA
Practice address
333 W Cork St Ste 290
Winchester, VA 22601-3870
Phone
(540) 536-5123
Fax
(540) 536-3261
NPI assigned
Feb 13, 2008
Last updated
Jul 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024178599 VA Primary
Family Nurse Practitioner 363LF0000X 62864 WV

Addresses

Primary practice location

333 W Cork St Ste 290
Winchester, VA 22601-3870

Mailing address

220 Campus Blvd Ste 100
Winchester, VA 22601-2888
Phone (540) 536-5100

Other practice location 1

351 Valley Health Way Ste 300
Front Royal, VA 22630-3598
Phone (540) 636-0300

Other practice location 2

759 S Main St
Woodstock, VA 22664-1154
Phone (540) 459-1100

Other practice location 3

200 Memorial Dr
Luray, VA 22835-1000
Phone (540) 536-5100

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address apetry664082@soc.inova.org
Direct Messaging Address apetry664082@soc.inova.org
Direct Messaging Address apetry664082@soc.inova.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, VA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140919000515 WV Practitioner - Nurse Practitioner 9436378650 Reassigns benefits to 1 organization
I20200311001022 VA Practitioner - Nurse Practitioner 9436378650 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
West Virginia University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley Physician Enterprise IncGroup PAC ID 9931268091, 176 clinicians

Practice addresses (Care Compare)

333 W Cork St
Suite 100
Winchester, VA 22601-3870
Phone (540) 536-0518

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
62864WVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Winchester Medical Center CurrentSince Jan 28, 2020 Accepting new patients
Shenandoah Memorial Hospital, Inc. CurrentSince Sep 1, 2023 Accepting new patients
Page Memorial Hospital, Inc. Family CurrentSince Sep 1, 2023 Accepting new patients
Warren Memorial Hospital, Inc. CurrentSince May 1, 2023 Accepting new patients
Valley Physician Enterprise, Inc. CurrentSince Jan 28, 2020 Accepting new patients
Valley Physician Enterprise, Inc. CurrentSince Jan 28, 2020 Accepting new patients
Page Memorial Hospital, Inc. CurrentSince Sep 1, 2023 Accepting new patients
University Healthcare Physicians Inc CurrentSince Jul 21, 2014 Accepting new patients
Warren Memorial Hospital, Inc. CurrentSince May 1, 2023 Accepting new patients
Valley Physician Enterprise, Inc Current Accepting new patients
Shenandoah Memorial Hospital, Inc. CurrentSince Sep 1, 2023 Accepting new patients
University Healthcare Physicians, Inc. Family CurrentSince Jul 21, 2014 Accepting new patients
Winchester Medical Center Current Accepting new patients
Winchester Medical Center CurrentSince Jan 28, 2020 Accepting new patients
Shenandoah Memorial Hospital, Inc. Current Accepting new patients
Shenandoah Memorial Hospital, Inc. Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
University Healthcare Physicians, Inc. PastSince Nov 6, 2022 Accepting new patients

Locations

1000 N Shenandoah Ave
Front Royal, VA 22630
Phone (540) 636-0300

351 Valley Health Way
Front Royal, VA 22630
Phone (540) 636-0300

351 Valley Health Way
Ste 300
Front Royal, VA 22630
Phone (540) 631-3700

200 Memorial Dr
Luray, VA 22835
Phone (540) 743-4561

1840 Amherst St
Winchester, VA 22601
Phone (540) 536-8700

220 Campus Blvd
Ste 100
Winchester, VA 22601

333 W Cork St
Ste 100
Winchester, VA 22601
Phone (540) 536-0518

333 W Cork St
Ste 290
Winchester, VA 22601
Phone (540) 536-5121

400 Campus Blvd
Ste 210
Winchester, VA 22601
Phone (540) 536-3470

240 Shenandoah St
Woodstock, VA 22664
Phone (540) 459-2808

759 S Main St
Woodstock, VA 22664
Phone (540) 459-1100

171 Taylor St
Harpers Ferry, WV 25425
Phone (304) 535-6343

2000 Foundation Way
Ste 3100
Martinsburg, WV 25401
Phone (304) 260-1436

2500 Foundation Way
Martinsburg, WV 25401
Phone (304) 264-9202

203 E 4th Ave
Ranson, WV 25438
Phone (304) 535-6343

Interoperability endpoints

  • Direct secure messaging: apetry664082@soc.inova.org
  • Direct secure messaging: apetry664082@valleyhealth.direct-ci.com

Organizations & group practices 18

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 18

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1202860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688688000000",
    "number": "1023286010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 CAMPUS BLVD STE 100",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226012888",
            "telephone_number": "540-536-5100",
            "fax_number": "540-536-0235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 W CORK ST STE 290",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226013870",
            "telephone_number": "540-536-5123",
            "fax_number": "540-536-3261"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "351 Valley Health Way Ste 300",
            "address_purpose": "LOCATION",
            "city": "Front Royal",
            "state": "VA",
            "postal_code": "226303598",
            "country_code": "US",
            "telephone_number": "540-636-0300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "759 S Main St",
            "address_purpose": "LOCATION",
            "city": "Woodstock",
            "state": "VA",
            "postal_code": "226641154",
            "country_code": "US",
            "telephone_number": "540-459-1100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 Memorial Dr",
            "address_purpose": "LOCATION",
            "city": "Luray",
            "state": "VA",
            "postal_code": "228351000",
            "country_code": "US",
            "telephone_number": "540-536-5100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETRY",
        "first_name": "ANGELA",
        "middle_name": "DAWN",
        "name_prefix": "Ms.",
        "credential": "N.P.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-13",
        "last_updated": "2023-07-07",
        "certification_date": "2023-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024178599",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "62864",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "apetry664082@soc.inova.org",
            "affiliation": "N",
            "address_1": "333 W Cork St Ste 290",
            "city": "Winchester",
            "state": "VA",
            "country_code": "US",
            "postal_code": "226013870",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "apetry664082@soc.inova.org",
            "affiliation": "N",
            "address_1": "1840 Amherst St",
            "city": "Winchester",
            "state": "VA",
            "country_code": "US",
            "postal_code": "226012808",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "apetry664082@soc.inova.org",
            "affiliation": "N",
            "address_1": "351 Valley Health Way Ste 300",
            "city": "Front Royal",
            "state": "VA",
            "country_code": "US",
            "postal_code": "226303598",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Winchester, VA

Sources for this page

Verify at the official NPI Registry.