Active NPI
Carl Petri, MD
- Surgery Physician
- Middlebury, VT
National Provider Identifier
1508818261
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 0420007280
- Practice address
- 116 Porter Dr
Middlebury, VT 05753-8527 - Phone
- (802) 388-9885
- Fax
- (802) 388-7120
- NPI assigned
- May 17, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 0420007280 | VT | Primary |
Addresses
Primary practice location
116 Porter Dr
Middlebury, VT 05753-8527
Mailing address
116 Porter Dr
Middlebury, VT 05753-8527
Phone (802) 388-9885
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0002513 | Medicaid | VT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0420007280 | VT | MD | Surgery Physician |
Interoperability endpoints
- cpetri15871@direct.uvmhealth.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147824000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1212969600000",
"number": "1508818261",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "116 PORTER DR",
"city": "MIDDLEBURY",
"state": "VT",
"postal_code": "057538527",
"telephone_number": "802-388-9885",
"fax_number": "802-388-7120"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "116 PORTER DR",
"city": "MIDDLEBURY",
"state": "VT",
"postal_code": "057538527",
"telephone_number": "802-388-9885",
"fax_number": "802-388-7120"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETRI",
"first_name": "CARL",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-17",
"last_updated": "2008-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "VT",
"license": "0420007280",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0002513",
"state": "VT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Middlebury, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.