Robert Petrino, MD, PA

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

C5439 Issued in AR

Legal business name

ROBERT PETRINO, MD, PA

Practice address

706 Quandt Ave
Ste a
Springdale, AR 72764

Phone

(479) 757-2030

Fax

(479) 750-6236

NPI assigned

Mar 16, 2016

Organization subpart

No

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

Authorized official

Name

Lori Justice

Title

Credentialing Officer

Phone

(539) 664-7190

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1458086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650585600000",
    "number": "1316308570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 343",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727650343",
            "telephone_number": "539-664-7190",
            "fax_number": "479-756-2721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "706 QUANDT AVE",
            "address_2": "STE A",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "72764",
            "telephone_number": "479-757-2030",
            "fax_number": "479-750-6236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT PETRINO, MD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-16",
        "last_updated": "2022-04-22",
        "certification_date": "2022-04-11",
        "status": "A",
        "authorized_official_last_name": "JUSTICE",
        "authorized_official_first_name": "LORI",
        "authorized_official_title_or_position": "CREDENTIALING OFFICER",
        "authorized_official_telephone_number": "539-664-7190"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "AR",
            "license": "C5439",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "214698002",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thomas Neal Ritter, PHD
• Jennifer Lyn Rizzo, MHPP
• Brandi Rachelle Roach, D.D.S
• Ciara Robbins
• Stephanie Robbins, APRN
• Robert Stark DDS PA
• Ashley Marie Roberts
• Charla Roberts, M.S.,CCC-SLP
• Emily Roberts, OTR
• Halee Fawne Roberts, LCSW

• Surgery Physician in Springdale, AR
• Providers in Springdale, AR by specialty
• Surgery Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.