Active NPI
Rodney Petrey
- General Practice Dentistry
- Lexington, KY
National Provider Identifier
1720293673
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 5915
- Practice address
- 2011 Rambler Rd
Suite 1
Lexington, KY 40503-2440 - Phone
- (859) 277-0011
- Fax
- (859) 277-1703
- NPI assigned
- May 14, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 5915 | KY | Primary |
Addresses
Primary practice location
2011 Rambler Rd
Suite 1
Lexington, KY 40503-2440
Mailing address
2011 Rambler Rd
Suite 1
Lexington, KY 40503-2440
Phone (859) 277-0011
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5915 | OH | MD | Clinical Child & Adolescent Psychologist |
| 5915 | KY | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179100800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1720293673",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2011 RAMBLER RD",
"address_2": "SUITE 1",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405032440",
"telephone_number": "859-277-0011",
"fax_number": "859-277-1703"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2011 RAMBLER RD",
"address_2": "SUITE 1",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405032440",
"telephone_number": "859-277-0011",
"fax_number": "859-277-1703"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETREY",
"first_name": "RODNEY",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "KY",
"license": "5915",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lexington, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.