Active NPI
Kristie Petree, D.O.
- Neuromusculoskeletal Medicine & OMM Physician
- Suwanee, GA
National Provider Identifier
1083053201
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neuromusculoskeletal Medicine & OMM Physician
- License
- 77507
- Practice address
- 625 Old Peachtree Rd NW
Suwanee, GA 30024-2937 - Phone
- (517) 432-6144
- Fax
- (517) 432-6150
- NPI assigned
- Jun 20, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neuromusculoskeletal Medicine & OMM Physician | 204D00000X | 77507 | GA | Primary |
Addresses
Primary practice location
625 Old Peachtree Rd NW
Suwanee, GA 30024-2937
Mailing address
PO Box 824112
Philadelphia, PA 19182-4112
Phone (215) 871-6562
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)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 77507 | GA | MD | Neuromusculoskeletal Medicine & OMM Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1371686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1500249600000",
"number": "1083053201",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 824112",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191824112",
"telephone_number": "215-871-6562"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "625 OLD PEACHTREE RD NW",
"city": "SUWANEE",
"state": "GA",
"postal_code": "300242937",
"telephone_number": "517-432-6144",
"fax_number": "517-432-6150"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETREE",
"first_name": "KRISTIE",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-06-20",
"last_updated": "2017-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "204D00000X",
"taxonomy_group": "",
"desc": "Neuromusculoskeletal Medicine & OMM",
"state": "GA",
"license": "77507",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Suwanee, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.