John Andrew Petery, DPM

Primary specialty

Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X

License

409 Issued in NC

Practice address

5921 W Friendly Ave Ste D
Greensboro, NC 27410-3268

Phone

(336) 218-8490

Fax

(336) 299-6533

NPI assigned

May 8, 2006

Last updated

Oct 8, 2020By 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 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Kent State University College of Podiatric Medicine, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Moses Cone Affiliated Physicians, Inc.Group PAC ID 3779635396, 80 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Moses H. Cone Memorial Hospital, the Hospital, Greensboro, NC, CCN 340091

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/3446/brand/1/csg/1/fhir/r4

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.

• Moses Cone Affiliated Physicians, Inc

  dba Greensboro Gynecology Associates

  • Obstetrics & Gynecology Physician
  • Greensboro, NC
  • NPI 1346474103
  Medicare reassignment Care Compare group NPD
• Foot Centers of NC, P.a.

  • Primary Podiatric Medicine Podiatrist
  • Winston Salem, NC
  • NPI 1033202957
  Authorized official Same address or phone
• Friendly Foot Centers, PLLC

  • Primary Podiatric Medicine Podiatrist
  • Greensboro, NC
  • NPI 1962993147
  Authorized official Same address or phone
• Moses Cone Affiliated Physicians, Inc.

  dba Gynecology Center of Greensboro

  • Gynecology Physician
  • Greensboro, NC
  • NPI 1417610627
  NPD
• Moses Cone Affiliated Physicians, Inc.

  dba Triad Foot and Ankle Center

  • Foot & Ankle Surgery Podiatrist
  • Greensboro, NC
  • NPI 1952614620

  Primary Podiatric Medicine

  NPD
• Carolina Anesthesia Associates PA

  • Anesthesiology Physician
  • Statesville, NC
  • NPI 1699723791
  NPD (past)
• Moses Cone Affiliated Physicians, Inc.

  dba Premier Pediatrics of Eden

  • Pediatrics Physician
  • Eden, NC
  • NPI 1114228475
  NPD (past)
• Ambulatory Foot Care Center P C

  • Podiatrist
  • Danville, VA
  • NPI 1801013115

  Primary Podiatric Medicine

  NPD (past)

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

• The Moses H. Cone Memorial Hospital Operating Corporation

  • General Acute Care Hospital
  • Greensboro, NC
  • NPI 1477591055
  Care Compare affiliation

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602115200000",
    "number": "1811946965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5921 W FRIENDLY AVE STE D",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274103268",
            "telephone_number": "336-218-8490",
            "fax_number": "336-299-6533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5921 W FRIENDLY AVE STE D",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274103268",
            "telephone_number": "336-218-8490",
            "fax_number": "336-299-6533"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3303 Healy Dr Ste B",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271031569",
            "country_code": "US",
            "telephone_number": "336-768-8848",
            "fax_number": "336-768-3078",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERY",
        "first_name": "JOHN",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-08",
        "last_updated": "2020-10-08",
        "certification_date": "2020-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "NC",
            "license": "409",
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NC",
            "license": "409",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "690193T",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890801U",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "U22761",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "10387801",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laura Johnson Peters, CRNA
• Patricia Peters, RN
• Nakia Oneaka Peterson Brown
• Joy Mauney Peterson, P.A.-C
• Stephanie Christen Pritchett Peterson, PA
• Angela Petracca, OD
• Brian D Petrarca, PA
• Taryn Elizabeth Petrillo
• Marcella Petrini, LPCA
• Jeffrey A Petrinitz, DPM

• Primary Podiatric Medicine Podiatrist in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Primary Podiatric Medicine Podiatrist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2020; 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.