Betty Petrillo, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1041917 Issued in TX

Practice address

2011 N Collins Blvd Ste 607
Richardson, TX 75080-2636

Phone

(800) 640-3451

NPI assigned

Oct 8, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Ronald N Skufca DO PA

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1558433250
  Medicare reassignment NPD
• Callon Doc

  • Physician Assistant
  • Dallas, TX
  • NPI 1366162042
  NPD (past)

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

{
    "created_epoch": "1633651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707696000000",
    "number": "1750043642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9888 AUTUMN SAGE DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761084812",
            "telephone_number": "972-795-1023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2011 N COLLINS BLVD STE 607",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750802636",
            "telephone_number": "800-640-3451"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5315 Ross Ave",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752067418",
            "country_code": "US",
            "telephone_number": "214-826-2151",
            "fax_number": "214-526-2196",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETRILLO",
        "first_name": "BETTY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-08",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1041917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristen Marie Petersen, CRNA
• Abigail Peterson, M.S., CCC-SLP
• Claire Elise Peterson, FNP-C
• Rani Peterson, LPC ASSOCIATE
• Tammy Petre
• Shae Petrusky, LPC
• Lesley Anne Pettit
• Kim Pham, PHARMD
• Lauren Hanh Pham
• Phat Pham

• Family Nurse Practitioner in Richardson, TX
• Providers in Richardson, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.