Carol Petry, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

71000346 Issued in IN

Practice address

9 N Crane Ave
Spencer, IN 47460-1507

Phone

(812) 829-2237

Fax

(812) 829-6342

NPI assigned

May 12, 2006

Last updated

Jul 28, 2011By 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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Indiana University Health Southern Indiana Physicians, LLC

  • Multi-Specialty Clinic/Center
  • Bloomington, IN
  • NPI 1013953983

  Nurse Practitioner

  NPD

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311811200000",
    "number": "1508816182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1329",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474021329",
            "telephone_number": "812-353-5855",
            "fax_number": "812-353-5867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 N CRANE AVE",
            "city": "SPENCER",
            "state": "IN",
            "postal_code": "474601507",
            "telephone_number": "812-829-2237",
            "fax_number": "812-829-6342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRY",
        "first_name": "CAROL",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-12",
        "last_updated": "2011-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71000346",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200202930A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ossip Optometry, P.C (Spencer Community Eyecare)
• Owen County Emergency Medical Services
• Owen County Family Young Men's Christian Association
• Owen County Health Department
• Margaret Eden Butler Pejeau, NP
• Kurt S Petry, O.D.
• Ashley Nicole Powell
• Proactive Mso, LLC (Spencer Health Center)
• Putnam County Hospital (Owen Valley Health Campus)
• RCG Bloomington, LLC (Fresenius Medical Care Spencer)

• Nurse Practitioner in Spencer, IN
• Providers in Spencer, IN by specialty
• Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2011; 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.