Heather Diane Petrovich, ARNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

ARNP3088822 Issued in FL

Practice address

2776 Cleveland Ave
#802
Fort Myers, FL 33901-5864

Phone

(239) 336-6174

Fax

(239) 335-6607

NPI assigned

Nov 15, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: hwilenius7036@direct.leememorial.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Lee Memorial Health System

  • Internal Medicine Physician
  • Fort Myers, FL
  • NPI 1992873319
  Medicare reassignment NPD
• Lee Memorial Health System

  • Federally Qualified Health Center (FQHC)
  • Port Charlotte, FL
  • NPI 1255171765
  NPD

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

{
    "created_epoch": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489536000000",
    "number": "1336121599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2532 KEYSTONE LAKE DR",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339092941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2776 CLEVELAND AVE",
            "address_2": "#802",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339015864",
            "telephone_number": "239-336-6174",
            "fax_number": "239-335-6607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETROVICH",
        "first_name": "HEATHER",
        "middle_name": "DIANE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-15",
        "last_updated": "2017-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP3088822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Raymond Petrarca, M.S., A.T.C
• Jaesen Petretta, OTR/L
• Gretchen Mary Petrie, PHARMD., CGP
• Aimie Petrikas, MA
• Judith Petrin, APRN
• Debbie Pettibone, LPN
• James A. Pettus, R.PH.
• Katlyn M Peyton, NP
• Ashley Eryn Pezzi, M.D.
• Reynaldo Pezzotti Smith, M.D

• Family Nurse Practitioner in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.