Active NPI
Austin James Petrie, PT, DPT
- Physical Therapist
- Beachwood, OH
National Provider Identifier
1790321669
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 017015
- Practice address
- 27300 Cedar Rd
Beachwood, OH 44122-1110 - Phone
- (216) 595-7345
- NPI assigned
- Nov 26, 2019
- Last updated
- Nov 26, 2019
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 017015 | OH | Primary |
Addresses
Primary practice location
27300 Cedar Rd
Beachwood, OH 44122-1110
Mailing address
1328 Gladys Ave
Lakewood, OH 44107-2512
Phone (419) 276-9081
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 017015 | OH | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1574726400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1574726400000",
"number": "1790321669",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1328 GLADYS AVE",
"city": "LAKEWOOD",
"state": "OH",
"postal_code": "441072512",
"telephone_number": "419-276-9081"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "27300 CEDAR RD",
"city": "BEACHWOOD",
"state": "OH",
"postal_code": "441221110",
"telephone_number": "216-595-7345"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETRIE",
"first_name": "AUSTIN",
"middle_name": "JAMES",
"name_prefix": "Dr.",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-11-26",
"last_updated": "2019-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OH",
"license": "017015",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beachwood, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.