Shirley Dols Petreye, ARNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0024172441 Issued in VA

Practice address

430 Boxwood LN
Pearisburg, VA 24134-1168

Phone

(540) 921-6110

Fax

(540) 921-3796

NPI assigned

Oct 11, 2005

Last updated

Feb 5, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

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.

• Medmark Services Inc.

  • VA Clinic/Center
  • Delray Beach, FL
  • NPI 1134302201
  NPD (past)

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

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549324800000",
    "number": "1396733580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 BOXWOOD LN",
            "city": "PEARISBURG",
            "state": "VA",
            "postal_code": "241341168",
            "telephone_number": "540-921-6110",
            "fax_number": "540-921-3796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 BOXWOOD LN",
            "city": "PEARISBURG",
            "state": "VA",
            "postal_code": "241341168",
            "telephone_number": "540-921-6110",
            "fax_number": "540-921-3796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETREYE",
        "first_name": "SHIRLEY",
        "middle_name": "DOLS",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-11",
        "last_updated": "2019-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "3187042",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024172441",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "3187042",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jake Daniel Norris, DO
• Madelyn Onesti
• Deanna Grace Parton
• Randall J Peck, MD
• Kayla Perdue
• Patti T. Price
• Quest Diagnostics Clinical Laboratories Inc
• Kimberly Leann Ratcliff, PHARMD
• Ava Hades Realy, LCSW
• Amanda Hale Reese, D.O.

• Family Nurse Practitioner in Pearisburg, VA
• Providers in Pearisburg, VA by specialty
• Family Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2019; 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.