Rebekah Paige Petriella, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

5015845 Issued in NC

Practice address

6047 Tyvola Glen Cir
Charlotte, NC 28217-6431

Phone

(443) 383-9300

Fax

(855) 866-8710

NPI assigned

Feb 17, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in NC

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

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Chma of NC

  • Internal Medicine Physician
  • Charlotte, NC
  • NPI 1982364469
  Medicare reassignment NPD
• Carolina Pain and Weight Loss, PA

  • Pain Medicine Physician
  • Salisbury, NC
  • NPI 1932936226

  Nurse Practitioner

  NPD (past)
• Southeast North Carolina Seven Medical Group, PLLC

  • Primary Care Clinic/Center
  • Houston, TX
  • NPI 1578221370
  NPD (past)
• Southwest Texas Two Medical Group, PLLC

  • Primary Care Clinic/Center
  • Houston, TX
  • NPI 1659950475
  NPD (past)

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

{
    "created_epoch": "1645056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737676800000",
    "number": "1366197402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1230 26TH AVE NE",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286017611",
            "telephone_number": "828-962-8481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6047 TYVOLA GLEN CIR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282176431",
            "telephone_number": "443-383-9300",
            "fax_number": "855-866-8710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRIELLA",
        "first_name": "REBEKAH",
        "middle_name": "PAIGE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-17",
        "last_updated": "2025-01-24",
        "certification_date": "2025-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1151725",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "APN.28370",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5015845",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "NNK757A",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "Q00382662",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1366197402",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Frank William Petraglia III, MD
• Camille Lynn Petraitis, FNP
• Stephanie Petraitis
• Danielle M. Petralia, CRNA
• Curtis Lee Petree, CRNA
• David Petrilli, DMD
• Devin Paige Petrone, MD
• Leslie H Petruk, LPC
• Eva Petrulis
• Elizabeth Zekan Petryna, D.D.S.

• Nurse Practitioner in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2025; 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.