NPIMap

Organization Active NPI

Dr Barbara Lynn Petkovic DPM LLC

  • Podiatrist
  • North Royalton, OH
National Provider Identifier
1548698368
Registry record updated Oct 23, 2013
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Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
DR BARBARA LYNN PETKOVIC DPM LLC
Practice address
10631 Sherwood TRL
North Royalton, OH 44133-1979
Phone
(440) 885-2130
Fax
(440) 848-8406
NPI assigned
Oct 15, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2013

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

Authorized official

Name
Dr. Barbara Lynn Petkovic, D.P.M.
Title
Owner
Phone
(440) 885-2130

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X OH Primary

Addresses

Primary practice location

10631 Sherwood TRL
North Royalton, OH 44133-1979

Mailing address

PO Box 33501
North Royalton, OH 44133-0501
Phone (440) 885-2130

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1381795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1382486400000",
    "number": "1548698368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 33501",
            "city": "NORTH ROYALTON",
            "state": "OH",
            "postal_code": "441330501",
            "telephone_number": "440-885-2130",
            "fax_number": "440-848-8406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10631 SHERWOOD TRL",
            "city": "NORTH ROYALTON",
            "state": "OH",
            "postal_code": "441331979",
            "telephone_number": "440-885-2130",
            "fax_number": "440-848-8406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR BARBARA LYNN PETKOVIC DPM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-15",
        "last_updated": "2013-10-23",
        "status": "A",
        "authorized_official_last_name": "PETKOVIC",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "440-885-2130",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Royalton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2013; 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.