Eddie P Petry, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1566 Issued in AL

Practice address

700 Al Highway 75 N
Albertville, AL 35951-4014

Phone

(256) 891-3733

Fax

(256) 891-0602

NPI assigned

Oct 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Petry Chiropractic Center LLC

  • Preferred Provider Organization
  • Albertville, AL
  • NPI 1023383163
  NPD (past) Authorized official

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332288000000",
    "number": "1093801912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 AL HIGHWAY 75 N",
            "city": "ALBERTVILLE",
            "state": "AL",
            "postal_code": "359514014",
            "telephone_number": "256-891-3733",
            "fax_number": "256-891-0602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 AL HIGHWAY 75 N",
            "city": "ALBERTVILLE",
            "state": "AL",
            "postal_code": "359514014",
            "telephone_number": "256-891-3733",
            "fax_number": "256-891-0602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRY",
        "first_name": "EDDIE",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2012-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AL",
            "license": "1566",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "51518312",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laura Beth Pearce
• Mallory Lauren Peel
• Performance Group Albertville
• Michael Wayne Peters, M.D.
• Petry Chiropractic Center LLC
• Mitchell Ewing Phillips
• Ploof Therapy LLC
• Ploof Therapy LLC
• Dennis Bradley Ploof, MS, LPC, NCC
• James William Porter II, D.M.D.

• Chiropractor in Albertville, AL
• Providers in Albertville, AL by specialty
• Chiropractor in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2012; 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.