Marian Petrides, MD

Primary specialty

Blood Banking & Transfusion Medicine PhysicianTaxonomy code 207ZB0001X

License

042-0006038 Issued in VT

Practice address

39 Wild Turkey LN
Waitsfield, VT 05673-7348

Phone

(802) 496-6175

NPI assigned

May 20, 2006

Last updated

Mar 1, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330560000000",
    "number": "1841244050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 WILD TURKEY LN",
            "city": "WAITSFIELD",
            "state": "VT",
            "postal_code": "056737348",
            "telephone_number": "802-496-6175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 WILD TURKEY LN",
            "city": "WAITSFIELD",
            "state": "VT",
            "postal_code": "056737348",
            "telephone_number": "802-496-6175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRIDES",
        "first_name": "MARIAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-20",
        "last_updated": "2012-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZB0001X",
            "taxonomy_group": "",
            "desc": "Pathology, Blood Banking & Transfusion Medicine",
            "state": "VT",
            "license": "042-0006038",
            "primary": true
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "VT",
            "license": "042-0006038",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Evan Matthew Oppenheimer, LCMHC
• Jessica Park
• Sarah R Pashby, PT
• Geoffrey G Regan, ATC, CSCS, PES
• Roberta C. Rood, Licsw
• Katelyn Roche
• Roberta C Rood, LICSW
• Devin Graham Rose, DC

• Blood Banking & Transfusion Medicine Physician in Waitsfield, VT
• Providers in Waitsfield, VT by specialty
• Blood Banking & Transfusion Medicine Physician in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2012; 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.