Individual provider Active NPI

Bethany Petrey

  • Advanced Practice Midwife
  • Louisville, KY
National Provider Identifier
1801664479
Registry record updated Dec 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
09000449C Issued in IN
Practice address
4001 Dutchmans LN
Louisville, KY 40207-4714
Phone
(502) 893-1270
Fax
(502) 894-1321
NPI assigned
Dec 13, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 09000449C IN Primary
Advanced Practice Midwife 367A00000X 4011242 KY

Addresses

Primary practice location

4001 Dutchmans LN
Louisville, KY 40207-4714

Mailing address

PO Box 776351
Chicago, IL 60677-6351
Phone (502) 588-9490

Other practice location 1

200 e chestnut st
Louisville, KY 40202-1831
Phone (502) 629-6065

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, KY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20241210001222 IN Practitioner - Certified Nurse Midwife (CNM) 8527594878 Reassigns benefits to 1 organization
I20260122002761 KY Practitioner - Certified Nurse Midwife (CNM) 8527594878 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Woman Care LLCGroup PAC ID 0749210748, 12 clinicians
Community Medical Associates IncGroup PAC ID 7012811284, 1,368 clinicians

Practice addresses (Care Compare)

301 Gordon Gutmann Blvd
Suite 201
Jeffersonville, IN 47130-3766
Phone (812) 282-6114

4001 Dutchmans LN
Louisville, KY 40207-4714
Phone (502) 893-1000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
4011242KYMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Woman Care, LLC Advanced Practice Midwife CurrentSince Dec 1, 2024 Accepting new patients
Community Medical Associates, Inc. CurrentSince Feb 1, 2026 Accepting new patients
Community Medical Associates, Inc. CurrentSince Feb 1, 2026 Accepting new patients
Tree of Life Family Birth Center Past Accepting new patients
Community Medical Associates, Inc. Past Accepting new patients

Locations

301 Gordon Gutmann Blvd
Ste 201
Jeffersonvlle, IN 47130
Phone (812) 282-6114

200 E Chestnut St
Louisville, KY 40202
Phone (502) 446-8000

825 Barret Ave
Louisville, KY 40204
Phone (502) 272-5165

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1702425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765929600000",
    "number": "1801664479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776351",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776351",
            "telephone_number": "502-588-9490",
            "fax_number": "502-272-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 DUTCHMANS LN",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074714",
            "telephone_number": "502-893-1270",
            "fax_number": "502-894-1321"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 e chestnut st",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402021831",
            "country_code": "US",
            "telephone_number": "502-629-6065",
            "fax_number": "502-894-1321",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETREY",
        "first_name": "BETHANY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-12-13",
        "last_updated": "2025-12-17",
        "certification_date": "2025-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "IN",
            "license": "09000449C",
            "primary": true
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "KY",
            "license": "4011242",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.