Active NPI
Mikalia Petro
- Registered Nurse
- Shelbyville, IN
National Provider Identifier
1548052210
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 28252639A
- Practice address
- 1641 Wichman LN
Shelbyville, IN 46176-5529 - Phone
- (513) 586-8966
- Fax
- (513) 586-8966
- NPI assigned
- May 20, 2025
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 28252639A | IN | Primary |
Addresses
Primary practice location
1641 Wichman LN
Shelbyville, IN 46176-5529
Mailing address
1641 Wichman Lane
Shelbyville, IN 46176
Phone (513) 586-8966
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28252639A | IN | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1747699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1747699200000",
"number": "1548052210",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1641 WICHMAN LANE",
"city": "SHELBYVILLE",
"state": "IN",
"postal_code": "46176",
"telephone_number": "513-586-8966",
"fax_number": "513-586-8966"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1641 WICHMAN LN",
"city": "SHELBYVILLE",
"state": "IN",
"postal_code": "461765529",
"telephone_number": "513-586-8966",
"fax_number": "513-586-8966"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETRO",
"first_name": "MIKALIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-05-20",
"last_updated": "2025-05-20",
"certification_date": "2025-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "IN",
"license": "28252639A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shelbyville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.