Individual provider Active NPI

Jeri Petro

  • School Psychologist
  • West Chester, OH
National Provider Identifier
1093139404
Registry record updated Feb 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
School PsychologistTaxonomy code 103TS0200X
License
MM1-02-2478 JJSF107 Issued in OH
Practice address
8940 Union Centre Blvd
West Chester, OH 45069-2948
Phone
(513) 682-4115
NPI assigned
Feb 6, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Psychologist 103TS0200X MM1-02-2478 JJSF107 OH Primary

Addresses

Primary practice location

8940 Union Centre Blvd
West Chester, OH 45069-2948

Mailing address

8940 Union Centre Blvd
West Chester, OH 45069-2948

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

NPI Registry JSON

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

{
    "created_epoch": "1391644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391644800000",
    "number": "1093139404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8940 UNION CENTRE BLVD",
            "city": "WEST CHESTER",
            "state": "OH",
            "postal_code": "450692948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8940 UNION CENTRE BLVD",
            "city": "WEST CHESTER",
            "state": "OH",
            "postal_code": "450692948",
            "telephone_number": "513-682-4115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRO",
        "first_name": "JERI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-02-06",
        "last_updated": "2014-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "OH",
            "license": "MM1-02-2478 JJSF107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Chester, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2014; 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.