Individual provider Active NPI

Kendra Anne Petruny, PA-C

  • Physician Assistant
  • Nashville, TN
National Provider Identifier
1154962413
Registry record updated Aug 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
6010 Issued in TN
Practice address
3601 The Vanderbilt Clinic
Nashville, TN 37232-2442
Phone
(615) 322-3000
NPI assigned
Oct 7, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA061177 PA
Physician Assistant 363A00000X 6010 TN Primary

Addresses

Primary practice location

3601 The Vanderbilt Clinic
Nashville, TN 37232-2442

Mailing address

3841 Green Hills Village Dr Ste 200
Nashville, TN 37215-2691

Other practice location 1

7600 Central Ave
Philadelphia, PA 19111-2442
Phone (215) 728-2276

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kpetruny819145@direct.vumc.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, TN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20191121000078 PA Practitioner - Physician Assistant 4587096003 Reassigns benefits to 2 organizations
I20241118000356 TN Practitioner - Physician Assistant 4587096003 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Temple University School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vanderbilt University Medical CenterGroup PAC ID 5092023416, 3,510 clinicians

Practice addresses (Care Compare)

1301 Medical Ctr Dr
Nashville, TN 37232-0028
Phone (615) 322-5000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.01 of 100Reported as apm
Quality
87.65
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
84.91 of 100Reported as group
Quality
73.58
Promoting interoperability
100
Improvement activities
40
Cost
76.13

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MA061177PAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Temple Physician Inc. CurrentSince Nov 15, 2019 Accepting new patients
Vanderbilt University Medical Center CurrentSince Aug 6, 2024 Accepting new patients
University of Penn-Medical Group CurrentSince Oct 4, 2021 Accepting new patients
University of Penn-Medical Group CurrentSince Oct 4, 2021 Accepting new patients
Temple Physicians Inc. Medical CurrentSince Nov 15, 2019 Accepting new patients

Locations

Dept A T 40379
Atlanta, GA 31192

515 Pennsylvania Ave
Fl 2
Ft Washington, PA 19034
Phone (215) 540-0120

7600 Central Ave
Philadelphia, PA 19111
Phone (215) 707-5522

3841 Green Hills Village Dr
Ste 200
Nashville, TN 37215
Phone (615) 322-6842

719 Thompson Ln
Nashville, TN 37204
Phone (615) 322-6485

Interoperability endpoints

  • Direct secure messaging: kpetruny819145@direct.vumc.org

Organizations & group practices 7

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1570406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723075200000",
    "number": "1154962413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3841 GREEN HILLS VILLAGE DR STE 200",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372152691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 THE VANDERBILT CLINIC",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372322442",
            "telephone_number": "615-322-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7600 Central Ave",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191112442",
            "country_code": "US",
            "telephone_number": "215-728-2276",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETRUNY",
        "first_name": "KENDRA",
        "middle_name": "ANNE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-07",
        "last_updated": "2024-08-08",
        "certification_date": "2024-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA061177",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "6010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kpetruny819145@direct.vumc.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Health Information Service Provider",
            "address_1": "3601 The Vanderbilt Clinic",
            "city": "Nashville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "372322442",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

Verify at the official NPI Registry.