Active NPI
Carolyn Petr
- Student in an Organized Health Care Education/Training Program
- Memphis, TN
National Provider Identifier
1699417923
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 920 Madison Avenue Suite 447
Memphis, TN 38163-5389 - Phone
- (615) 222-4075
- NPI assigned
- Apr 7, 2022
- 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
920 Madison Avenue Suite 447
Memphis, TN 38163-5389
Mailing address
4220 Harding Pike
Nashville, TN 37205
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230710000321 | TN | Order and Referring Only - General Surgery | 6800255886 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1649289600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687651200000",
"number": "1699417923",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4220 HARDING PIKE",
"city": "NASHVILLE",
"state": "TN",
"postal_code": "37205"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "920 MADISON AVENUE SUITE 447",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381635389",
"telephone_number": "615-222-4075"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETR",
"first_name": "CAROLYN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-04-07",
"last_updated": "2023-06-25",
"certification_date": "2023-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Memphis, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2023; 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.