Ralph Lynn Petrilli, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

40734 Issued in CO

Practice address

1181 Wyndemere Cir
Longmont, CO 80501-2321

Phone

(303) 651-5111

NPI assigned

Jun 12, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• One Anesthesia PLLC

  • Anesthesiology Physician
  • Louisville, KY
  • NPI 1174513246
  NPD (past)

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473984000000",
    "number": "1558303891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "744 W MICHIGAN AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011909",
            "telephone_number": "517-787-6440",
            "fax_number": "517-787-4146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1181 WYNDEMERE CIR",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805012321",
            "telephone_number": "303-651-5111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRILLI",
        "first_name": "RALPH",
        "middle_name": "LYNN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2016-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CO",
            "license": "40734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathryn Ann Petersen, MSW
• Riley Michael Richard Petersen, DDS
• Angela M Peterson, PHARM.D.
• Madison Grey Peterson, APRN-CNP
• Michael Peterson, MSPT
• Kaitlin R Petschke
• Lyle M Pfeifer, MD
• Sarah Phyllis Janine Pfeiffer
• PH Balance Advocates
• PH Balance Behavioral

• Specialist in Longmont, CO
• Providers in Longmont, CO by specialty
• Specialist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2016; 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.