Devin Lee Petulla, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

SP015013 Issued in PA

Practice address

222 Chestnut Ave
Altoona, PA 16601-4928

Phone

(814) 946-8046

Fax

(814) 946-3693

NPI assigned

Jun 1, 2015

Last updated

Apr 13, 2016By the provider in NPPES

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 names 1

• Devin Burnsworth Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 1, 2023 through Apr 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

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.

• Hampton Direct Primary Care

  dba Hampton Medical Direct Primary Care

  • Primary Care Clinic/Center
  • Altoona, PA
  • NPI 1306406855
  NPD (past)
• Windber Hospital, Inc.

  dba Windber Medical Center

  • General Acute Care Hospital
  • Windber, PA
  • NPI 1275620536
  NPD (past)

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

{
    "created_epoch": "1433116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460505600000",
    "number": "1033599519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 CHESTNUT AVE",
            "city": "ALTOONA",
            "state": "PA",
            "postal_code": "166014928",
            "telephone_number": "814-946-8046",
            "fax_number": "814-946-3693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 CHESTNUT AVE",
            "city": "ALTOONA",
            "state": "PA",
            "postal_code": "166014928",
            "telephone_number": "814-946-8046",
            "fax_number": "814-946-3693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETULLA",
        "first_name": "DEVIN",
        "middle_name": "LEE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-01",
        "last_updated": "2016-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP015013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEVIN",
            "last_name": "BURNSWORTH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Darren Petrunak, CRNP
• Eric M Petrunak, CRNA
• Fred E Petrunak, OD
• Jody Petrunak
• Eric Evan Petterson II, DO
• J Richard Pfeffer Jr., DMD
• Paige Pfeffer, DMD
• Peter Cong Pham, DDS
• Thomas Pham, MD
• Khadia M Phillip, M.D.

• Family Nurse Practitioner in Altoona, PA
• Providers in Altoona, PA by specialty
• Family Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.