Active NPI
Joann Petanovich, RD,LDN
- Registered Dietitian
- Butler, PA
National Provider Identifier
1609976091
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DN001322
- Practice address
- 325 New Castle Rd
Dept. 102
Butler, PA 16001-2418 - Phone
- (724) 287-4781
- Fax
- (724) 477-5069
- NPI assigned
- Sep 25, 2006
- 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 Dietitian | 133V00000X | DN001322 | PA | Primary |
Addresses
Primary practice location
325 New Castle Rd
Dept. 102
Butler, PA 16001-2418
Mailing address
325 New Castle Rd
Dept. 102
Butler, PA 16001-2418
Phone (724) 287-4781
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 |
|---|---|---|---|
| DN001322 | PA | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1322697600000",
"number": "1609976091",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "325 NEW CASTLE RD",
"address_2": "DEPT. 102",
"city": "BUTLER",
"state": "PA",
"postal_code": "160012418",
"telephone_number": "724-287-4781"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "325 NEW CASTLE RD",
"address_2": "DEPT. 102",
"city": "BUTLER",
"state": "PA",
"postal_code": "160012418",
"telephone_number": "724-287-4781",
"fax_number": "724-477-5069"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETANOVICH",
"first_name": "JOANN",
"credential": "RD,LDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-25",
"last_updated": "2011-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "PA",
"license": "DN001322",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Butler, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.