Aaron Dewayne Petrey, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA2574 Issued in KY

Practice address

475 N Highway 25 W Ste 100
Williamsburg, KY 40769-1576

Phone

(606) 549-2930

NPI assigned

Dec 18, 2019

Last updated

Dec 5, 2024By the provider in NPPES

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in KY, TN2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Lincoln Memorial University Medical Department, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Williamsburg Family Medicine CenterGroup PAC ID 2365331188, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Health Corbin Hospital, Corbin, KY, CCN 180080

Medicare enrollment (NPD)

Enrolled

Interoperability endpoints

• Direct secure messaging: aaron.petrey.1@24026.direct.athenahealth.com
• Direct secure messaging: aaron.petrey.1@24159.direct.athenahealth.com

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.

• Williamsburg Family Medicine Center

  • Rural Health Clinic/Center
  • Williamsburg, KY
  • NPI 1376689620
  Medicare reassignment Care Compare group
• Charles H. Wilkens, M.D.,P.C.

  • Rural Health Clinic/Center
  • Jellico, TN
  • NPI 1992841233
  Medicare reassignment

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Baptist Healthcare System, Inc

  dba Baptist Health Corbin

  • General Acute Care Hospital
  • Corbin, KY
  • NPI 1902865389
  Care Compare affiliation

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

{
    "created_epoch": "1576627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733356800000",
    "number": "1710525944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 247",
            "city": "JELLICO",
            "state": "TN",
            "postal_code": "377620247",
            "telephone_number": "423-784-0269",
            "fax_number": "423-784-3708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 N HIGHWAY 25 W STE 100",
            "city": "WILLIAMSBURG",
            "state": "KY",
            "postal_code": "407691576",
            "telephone_number": "606-549-2930"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "131 Hospital Ln",
            "address_purpose": "LOCATION",
            "city": "Jellico",
            "state": "TN",
            "postal_code": "377624404",
            "country_code": "US",
            "telephone_number": "423-784-7269",
            "fax_number": "423-784-3708",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETREY",
        "first_name": "AARON",
        "middle_name": "DEWAYNE",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-12-18",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "KY",
            "license": "PA2574",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100652600",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q056813",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Connor Garrett Partin
• Lindsey Nicole Patrick, APRN
• Robert Lee Penn, MD
• Eddie Steely Perkins, D.O.
• Taylor R Perkins, PMHNP-BC
• Kelsey Petrey, OTR/L
• Zachary Phillips, ATC, LAT
• Edward Jonathan Powers
• Roger Powers, PHARMACIST
• Preferred Healthcare Incorporated

• Medical Physician Assistant in Williamsburg, KY
• Providers in Williamsburg, KY by specialty
• Medical Physician Assistant in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.