Individual provider Active NPI

Jamie Petrel

  • Physical Therapist
  • Aliquippa, PA
National Provider Identifier
1194139774
Registry record updated Oct 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
023294 Issued in PA
Practice address
616 Golf Course Rd
Aliquippa, PA 15001-1110
Phone
(724) 375-0345
NPI assigned
Jun 11, 2014
Last updated
Oct 31, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2305213121 VA
Physical Therapist 225100000X 12595 TN
Physical Therapist 225100000X 023294 PA Primary

Addresses

Primary practice location

616 Golf Course Rd
Aliquippa, PA 15001-1110

Mailing address

667 Cedar Grove Rd
Burgettstown, PA 15021-9773
Phone (724) 302-6409

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240122001345 WV Practitioner - Physical Therapist in Private Practice 8729430178 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
WV Therapy Services LLCGroup PAC ID 8123106416, 26 clinicians

Practice addresses (Care Compare)

415 Benedum Dr
Bridgeport, WV 26330-1503
Phone (304) 842-9887

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12595TNMDGeneral Practice Dentistry
023294PAMDPhysical Therapist
2305213121VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
WV Therapy Services LLC CurrentSince Nov 22, 2023 Accepting new patients

Locations

415 Benedum Dr
Bridgeport, WV 26330
Phone (304) 842-9887

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1402444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572480000000",
    "number": "1194139774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "667 CEDAR GROVE RD",
            "city": "BURGETTSTOWN",
            "state": "PA",
            "postal_code": "150219773",
            "telephone_number": "724-302-6409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 GOLF COURSE RD",
            "city": "ALIQUIPPA",
            "state": "PA",
            "postal_code": "150011110",
            "telephone_number": "724-375-0345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETREL",
        "first_name": "JAMIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-11",
        "last_updated": "2019-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305213121",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "12595",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "023294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aliquippa, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.