Active NPI
Paul J Petrozzo, M.D.
- Diagnostic Radiology Physician
- Grundy, VA
National Provider Identifier
1184625337
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 0101237174
- Practice address
- RR 5 Box 20
State Route 83
Grundy, VA 24614-9611 - Phone
- (276) 523-7938
- NPI assigned
- Aug 9, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 0101237174 | VA | Primary |
Addresses
Primary practice location
RR 5 Box 20
State Route 83
Grundy, VA 24614-9611
Mailing address
116 Fairview St
Grundy, VA 24614-9415
Phone (276) 935-8268
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 010129231 | Medicaid | VA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found.
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Appalachian Diagnostic Imaging, P.C. | Diagnostic Radiology | Past | Accepting new patients |
| Buchanan Radiology Associates, Inc | Diagnostic Radiology | Past | Accepting new patients |
| Carilion Healthcare Corporation | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Diagnostic Radiology Physician
- Grundy, VA
- NPI 1588691539
-
- Diagnostic Radiology Physician
- Grundy, VA
- NPI 1235224460
-
dba Bridgewater College Student Health Center
- Multi-Specialty Clinic/Center
- Roanoke, VA
- NPI 1447206370
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1426204800000",
"number": "1184625337",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "116 FAIRVIEW ST",
"city": "GRUNDY",
"state": "VA",
"postal_code": "246149415",
"telephone_number": "276-935-8268"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "RR 5 BOX 20",
"address_2": "STATE ROUTE 83",
"city": "GRUNDY",
"state": "VA",
"postal_code": "246149611",
"telephone_number": "276-523-7938"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETROZZO",
"first_name": "PAUL",
"middle_name": "J",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-09",
"last_updated": "2015-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "VA",
"license": "0101237174",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "010129231",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Grundy, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.