Kyndall Leigh Petry
Individual provider Active NPI Family Nurse Practitioner · Fairview, TN
NPI 1134875842 · NPPES record last updated Oct 2, 2025
Key facts
- NPI
- 1134875842
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 31078 (TN)
- Practice address
- 2340 Fairview Blvd Ste 600D
Fairview, TN 37062-9457 - Phone
- (615) 266-2177
- NPI assigned
- Feb 22, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Advanced Diagnostic Imaging PC
Practice addresses (Care Compare)
3024 Business Park Cir
Goodlettsville, TN 37072-3132
Phone (615) 851-6033
Hospital & facility affiliations
- Home Care Solutions
- Tristar Horizon Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220901001885 | TN | Practitioner - Nurse Practitioner | 7113301623 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advanced Diagnostic Imaging, PC | Current |
Accepting new patients | |
| Privia Medical Group Tennessee LLC | Current |
Accepting new patients | |
| Privia Medical Group Tennessee LLC | Current |
Accepting new patients | |
| Advanced Diagnostic Imaging PC | Current |
Accepting new patients |
Locations
200 Creekside Dr
Dickson, TN 37055
Phone (615) 441-6140
2340 Fairview Blvd
Ste 600D
Fairview, TN 37062
Phone (615) 266-2177
3024 Business Park Cir
Goodlettsvlle, TN 37072
Phone (615) 239-2018
1009 N Locust Ave
Lawrenceburg, TN 38464
Phone (931) 244-7181
1800 Medical Center Pkwy
Ste 460
Murfreesboro, TN 37129
Phone (615) 217-3520
3443 Dickerson Pike
Ste 400
Nashville, TN 37207
Phone (615) 612-2146
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 31078 | TN | Yes |
Addresses
Primary practice location
2340 Fairview Blvd Ste 600D
Fairview, TN 37062-9457
Mailing address
3024 Business Park Cir
Goodlettsville, TN 37072-3132
Phone (615) 239-2018
Other practice location 1
1800 Medical Center Pkwy Ste 460
Murfreesboro, TN 37129-3181
Phone (615) 239-2062
Other practice location 2
200 Creekside Dr
Dickson, TN 37055-2176
Phone (615) 441-6140
Other providers in Fairview, TN
- Nash Eye Care PLLC
- Jason S Nash
- Nursing Home Eyecare PLLC
- Kelly Ann Olsen
- Susan Bowman Pemberton
- Tabitha Christina Phillips Bassett
- Selena Phillips
- Piece of Mind Learning Center, LLC
- Provision Family Dental, PLLC D/B/a Fairview Family Dentistry
- Publix Tennessee LLC
All providers in Fairview, TN · Family Nurse Practitioner in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 2, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.