Leah D Petrunger, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

564 Issued in WV

Practice address

150 Misty Lane
Princeton, WV 24740

Phone

(304) 425-4040

Fax

(304) 425-4041

NPI assigned

Oct 2, 2006

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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Lung Disease and Sleep Disorders Inc.

  • Pulmonary Disease Physician
  • Princeton, WV
  • NPI 1902084072
  NPD (past)
• The Lung Center

  • Specialist
  • Princeton, WV
  • NPI 1508051756
  NPD (past)
• C.P. Vasudevan,M.D.,P.C.

  • Pulmonary Disease Physician
  • Bluefield, VA
  • NPI 1821288804
  NPD (past)

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481155200000",
    "number": "1104919828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 HUNTER PARK",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247402533",
            "telephone_number": "304-920-5122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 MISTY LANE",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "24740",
            "telephone_number": "304-425-4040",
            "fax_number": "304-425-4041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRUNGER",
        "first_name": "LEAH",
        "middle_name": "D",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2016-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WV",
            "license": "564",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810002620",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samantha Perry
• Lori Lee Persinger-Lovern, PT, OCS
• Naeem Pervaiz, MD
• Jana Michelle Peters, DO
• Phillip Allen Peterson, MD
• Aaron Zane Pettrey
• Jennifer Pettry, DSP
• Kaleigh Peyton, RN
• Philip J Branson M D P C Inc
• Amanda Phillips, LSW

• Physician Assistant in Princeton, WV
• Providers in Princeton, WV by specialty
• Physician Assistant in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2016; 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.