Diane L Petrilla, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

017129 Issued in TN

Practice address

2240 Sutherland Ave
Suite 104
Knoxville, TN 37919-2333

Phone

(865) 909-0090

Fax

(865) 909-9883

NPI assigned

Jan 25, 2006

Last updated

Feb 14, 2013By 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 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/1292/brand/1/csg/41/fhir/r4

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.

• Cumberland Healthcare Group PLLC

  dba Sewanee Family Practice

  • Family Medicine Physician
  • Sewanee, TN
  • NPI 1316152994
  NPD (past)
• Cumberland Healthcare Group PLLC

  dba Winchester Primary Care

  • Family Medicine Physician
  • Decherd, TN
  • NPI 1770798886
  NPD (past)
• Roane County Medical Center

  dba Covenant Health Roane

  • General Acute Care Hospital
  • Harriman, TN
  • NPI 1700036696
  NPD (past)
• Sewanee Family Practice PLLC

  • Family Medicine Physician
  • Sewanee, TN
  • NPI 1063817625
  NPD (past)
• Summit Medical Group PLLC

  dba Summit Medical Group of Oak Ridge

  • Family Medicine Physician
  • Oak Ridge, TN
  • NPI 1437238797
  NPD (past)
• Summit Medical Group,PLLC

  dba Summit Medical Group of Cookeville

  • Internal Medicine Physician
  • Cookeville, TN
  • NPI 1588362164
  NPD (past)

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360800000000",
    "number": "1114997830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 E WEISGARBER RD",
            "address_2": "SUITE 200",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379092604",
            "telephone_number": "865-584-4747",
            "fax_number": "865-584-1363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2240 SUTHERLAND AVE",
            "address_2": "SUITE 104",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379192333",
            "telephone_number": "865-909-0090",
            "fax_number": "865-909-9883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRILLA",
        "first_name": "DIANE",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-25",
        "last_updated": "2013-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "017129",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "32266",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NH",
            "license": "15138",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP ID",
            "identifier": "3373633",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ayrias Petitt
• Brenda Petitt, RBT
• Elanor Petree
• Elizabeth R. Petree, BS
• Whitney J Petree
• Peter T Petruzzi Jr., MD
• Jamie K Pettet
• Marianna Grace Pettit
• Tanner Matthew Pettit, MD
• Colton Ryan Petty, MD

• Family Medicine Physician in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2013; 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.