Individual provider Active NPI

Christopher L Petrey, DO

  • Critical Care Medicine (Internal Medicine) Physician
  • Springfield, MO
National Provider Identifier
1245551795
Registry record updated Oct 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
2013015508 Issued in MO
Practice address
1235 E Cherokee St
Springfield, MO 65804-2203
Phone
(417) 820-3344
NPI assigned
Jun 18, 2010
Last updated
Oct 4, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2022

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

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Internal Medicine Physician 207R00000X 02006680A IN
Internal Medicine Physician 207R00000X 2013015508 MO
Internal Medicine Physician 207R00000X DO2344 TN
Internal Medicine Physician 207R00000X 03666 KY
Addiction Medicine (Internal Medicine) Physician 207RA0401X 03666 KY
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 02006680A IN
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 2013015508 MO Primary
Infectious Disease Physician 207RI0200X 05-37065 KS

Addresses

Primary practice location

1235 E Cherokee St
Springfield, MO 65804-2203

Mailing address

PO Box 990
Danville, KY 40423-0990
Phone (859) 239-2360

Other identifiers 3

IdentifierTypeStateIssuer
PENDINGMedicaidAR
PENDINGMedicaidMO
PENDINGMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, SC, VI, KY, IN5 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 5

Enrollment IDStateProvider typePAC IDDetails
I20131014001734 MO Practitioner - Internal Medicine 6002052644 Reassigns benefits to 1 organization
I20190403000067 SC Practitioner - Critical Care (Intensivists) 6002052644 Reassigns benefits to 1 organization
I20190522000335 VI Practitioner - Critical Care (Intensivists) 6002052644 Reassigns benefits to 1 organization
I20190718003680 KY Practitioner - Internal Medicine 6002052644 Reassigns benefits to 1 organization
I20220719002332 IN Practitioner - Critical Care (Intensivists)Practitioner - Internal Medicine 6002052644 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)Also: Internal Medicine
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New Albany Hospitalist Group LLCGroup PAC ID 4880041409, 69 clinicians

Practice addresses (Care Compare)

1850 State St
New Albany, IN 47150-4990
Phone (812) 944-7701

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
03666KYMDAddiction Medicine (Internal Medicine) Physician
2013015508MOMDCritical Care Medicine (Internal Medicine) Physician
05-37065KSMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ephraim McDowell Health Resource, Inc CurrentSince Jul 15, 2019 Accepting new patients
McLeod Regional Medical Center of the Pee Dee, Inc Internal Medicine CurrentSince Jan 9, 2019 Accepting new patients
Ephraim McDowell Health Resource, Inc CurrentSince Jul 15, 2019 Accepting new patients
New Albany Hospitalist Group, LLC CurrentSince Oct 1, 2023 Accepting new patients
Hospitalist Physicians of Indiana, PC Internal Medicine CurrentSince Jan 1, 2023 Accepting new patients
Ephraim McDowell Health Resource, Inc. Current Accepting new patients
Porter Physician Services LLC Internal Medicine CurrentSince Jun 1, 2022 Accepting new patients
Governor Juan F. Luis Hospital & Medical Center CurrentSince Nov 13, 2018 Accepting new patients
McLeod Regional Medical Center of the Pee Dee, Inc CurrentSince Jan 9, 2019 Accepting new patients
Governor Juan F. Luis Hospital & Medical Center CurrentSince Nov 13, 2018 Accepting new patients
Mineral Area Osteopathic Hospital Inc Internal Medicine Past Accepting new patients
Northwest Indiana Nephrology PC Past Accepting new patients

Locations

650 Dickinson Rd
Ste Z
Chesterton, IN 46304
Phone (219) 464-9507

7950 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 434-7088

1850 State St
New Albany, IN 47150
Phone (812) 944-7701

85 E US Highway 6
Valparaiso, IN 46383
Phone (219) 983-5743

109 Daniel Dr
Danville, KY 40422
Phone (859) 236-3361

216 W Walnut St
Ste A
Danville, KY 40422
Phone (859) 239-5870

555 E Cheves St
Florence, SC 29506
Phone (843) 662-5233

4007 Estate Diamond Ruby
St Croix, VI 00820
Phone (340) 772-7423

Organizations & group practices 13

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.

View all 13

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": "1276819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664841600000",
    "number": "1245551795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 990",
            "city": "DANVILLE",
            "state": "KY",
            "postal_code": "404230990",
            "telephone_number": "859-239-2360",
            "fax_number": "859-239-6785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1235 E CHEROKEE ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658042203",
            "telephone_number": "417-820-3344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETREY",
        "first_name": "CHRISTOPHER",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-18",
        "last_updated": "2022-10-04",
        "certification_date": "2022-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "02006680A",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2013015508",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "DO2344",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "03666",
            "primary": false
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "KY",
            "license": "03666",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "IN",
            "license": "02006680A",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "MO",
            "license": "2013015508",
            "primary": true
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "KS",
            "license": "05-37065",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.