Active NPI
Claudine L Petrovic, RN
- Registered Nurse
- Ithaca, NY
National Provider Identifier
1194133256
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 508229
- Practice address
- 132 Bundy Rd
Ithaca, NY 14850-9252 - Phone
- (607) 379-6048
- NPI assigned
- Jul 31, 2014
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 508229 | NY | Primary |
Addresses
Primary practice location
132 Bundy Rd
Ithaca, NY 14850-9252
Mailing address
132 Bundy Rd
Ithaca, NY 14850-9252
Phone (607) 379-6048
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 508229 | NY | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1406764800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1406764800000",
"number": "1194133256",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "132 BUNDY RD",
"city": "ITHACA",
"state": "NY",
"postal_code": "148509252",
"telephone_number": "607-379-6048"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "132 BUNDY RD",
"city": "ITHACA",
"state": "NY",
"postal_code": "148509252",
"telephone_number": "607-379-6048"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETROVIC",
"first_name": "CLAUDINE",
"middle_name": "L",
"name_prefix": "Mrs.",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-07-31",
"last_updated": "2014-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NY",
"license": "508229",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ithaca, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.