Amy M. Petrillo, C.N.P.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

COA 13890-NP Issued in OH

Practice address

1302 W Main St
Ste. a
Louisville, OH 44641-1114

Phone

(330) 875-5544

Fax

(330) 875-8150

NPI assigned

Sep 21, 2012

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

Enrolled in OH

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 1

Specialty

Nurse Practitioner

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Community Health Care Inc.Group PAC ID 1052207727, 65 clinicians

Ohio Specialty Physicians CorporationGroup PAC ID 3476643479, 67 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Aultman Hospital Hospital, Canton, OH, CCN 360084
• Mercy Medical Center Hospital, Canton, OH, CCN 360070
• Alliance Community Hospital Hospital, Alliance, OH, CCN 360131

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: amy.petrillo@chci.eclinicaldirectplus.com

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.

• Community Health Care Inc.

  • Family Medicine Physician
  • Canal Fulton, OH
  • NPI 1114902137
  Medicare reassignment Care Compare group NPD
• Ohio Specialty Physicians Corporation

  • Surgery Physician
  • Canton, OH
  • NPI 1285745364
  Medicare reassignment Care Compare group NPD
• Ohio Specialty Physicians Corporation

  • Durable Medical Equipment & Medical Supplies
  • North Canton, OH
  • NPI 1972299063
  NPD
• Radiology Associates of Canton, Inc.

  • Diagnostic Radiology Physician
  • Canton, OH
  • NPI 1912982034
  NPD (past)

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

• Alliance Community Hospital

  • General Acute Care Hospital
  • Alliance, OH
  • NPI 1942385794
  Care Compare affiliation
• Aultman Hospital

  • General Acute Care Hospital
  • Canton, OH
  • NPI 1356366991
  Care Compare affiliation
• Cleveland Clinic Mercy Hospital

  • General Acute Care Hospital
  • Canton, OH
  • NPI 1366433195
  Care Compare affiliation

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

{
    "created_epoch": "1348185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466467200000",
    "number": "1174874846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1302 W MAIN ST",
            "address_2": "STE. A",
            "city": "LOUISVILLE",
            "state": "OH",
            "postal_code": "446411114",
            "telephone_number": "330-875-5544",
            "fax_number": "330-875-8150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1302 W MAIN ST",
            "address_2": "STE. A",
            "city": "LOUISVILLE",
            "state": "OH",
            "postal_code": "446411114",
            "telephone_number": "330-875-5544",
            "fax_number": "330-875-8150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRILLO",
        "first_name": "AMY",
        "middle_name": "M.",
        "credential": "C.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-21",
        "last_updated": "2016-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "COA 13890-NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0073609",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jill L. Parrish, M.D.
• Becky Parson
• Pastures of Hope LLC
• Pearl Clinical Solutions
• Steven Frederick Peters, D.M.D
• Paulette R Phillips, R.N.
• Vincenzo D Pilolli, CNP
• Progressive Green Meadows LLC
• Progressive Green Meadows, LLC
• Progressive Quality Care Inc

• Family Nurse Practitioner in Louisville, OH
• Providers in Louisville, OH by specialty
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.