Linda Joyce Petrusick, NP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

P2239 Issued in SC

Practice address

57 Jessamine Street
Georgetown, SC 29442

Phone

(843) 546-8686

Fax

(843) 546-1353

NPI assigned

Dec 5, 2007

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

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.

• Georgetown Pediatric Center

  • Rural Health Clinic/Center
  • Georgetown, SC
  • NPI 1013334200
  NPD (past)
• Georgetown Pediatric Center, PC

  • Pediatrics Physician
  • Georgetown, SC
  • NPI 1760682637
  NPD (past)

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

{
    "created_epoch": "1196812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196812800000",
    "number": "1588846166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 JESSAMINE STREET PO BOX 618",
            "city": "GEORGETOWN",
            "state": "SC",
            "postal_code": "29442",
            "telephone_number": "843-546-8686",
            "fax_number": "843-546-1353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 JESSAMINE STREET",
            "city": "GEORGETOWN",
            "state": "SC",
            "postal_code": "29442",
            "telephone_number": "843-546-8686",
            "fax_number": "843-546-1353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRUSICK",
        "first_name": "LINDA",
        "middle_name": "JOYCE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-05",
        "last_updated": "2007-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "SC",
            "license": "P2239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Baker Patterson, APRN
• Annacecilia Peacher-Holderied, M.D.
• Timonthy J Pence, DMD MSD
• Sheila H Pender, RPH
• Karen K Perry, HIS
• Phil'S Pharmacy Inc
• Marie M Philipp, OTR/L
• Andrew Jay Phipps
• Michael Eugene Piepenbring
• Stephen James Pigman, MSPAS

• Pediatric Nurse Practitioner in Georgetown, SC
• Providers in Georgetown, SC by specialty
• Pediatric Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2007; 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.