Jeffrey W Petry, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

35.051279 Issued in OH

Practice address

30 E Apple St
Ste 3300
Dayton, OH 45409-2939

Phone

(937) 208-8394

Fax

(937) 208-8388

NPI assigned

Jan 4, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Five Rivers Health Centers

  • Family Medicine Physician
  • Dayton, OH
  • NPI 1669143061
  Medicare reassignment
• Five Rivers Health Centers

  • Family Medicine Physician
  • Dayton, OH
  • NPI 1053600775
  NPD
• Five Rivers Health Centers

  • Family Medicine Physician
  • Xenia, OH
  • NPI 1083501415
  NPD
• Five Rivers Health Centers

  dba Five Rivers Health Centers at St Vincent De Paul

  • Family Medicine Physician
  • Dayton, OH
  • NPI 1891302188
  NPD
• Lima Memorial Joint Operating Company

  dba Lima Memorial Health System

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)
• Samaritan Emergency Corp

  • Emergency Medicine Physician
  • Dayton, OH
  • NPI 1922084136
  NPD (past)
• South Dayton Acute Care Consultants, Inc

  • Internal Medicine Physician
  • Dayton, OH
  • NPI 1669442950

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1136332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385337600000",
    "number": "1689652372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 E APPLE ST",
            "address_2": "STE 3300",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454092939",
            "telephone_number": "937-208-8394",
            "fax_number": "937-208-8388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 E APPLE ST",
            "address_2": "STE 3300",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454092939",
            "telephone_number": "937-208-8394",
            "fax_number": "937-208-8388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRY",
        "first_name": "JEFFREY",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-04",
        "last_updated": "2013-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OH",
            "license": "35-051279",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35.051279",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0593666",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Haley Petri, PT, DPT
• Michael Petrie
• Mary Beth Petrosh
• Francis Edward Petrus
• Andrew James Petry, PA-C
• Lauren Petry, RPH
• Davina Pettaway, MS,MA LPC, LICDC-CS
• Jan Pettibone, OT/L
• Amanda Pettit
• Lexis Petty

• Family Medicine Physician in Dayton, OH
• Providers in Dayton, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.