John William Petras, PH.D.

Primary specialty

Social WorkerTaxonomy code 104100000X

License

6801034726 Issued in MI

Practice address

615 E. Wisconsin Street
Mount Pleasant, MI 48858-2767

Phone

(989) 773-9600

Fax

(989) 772-3387

NPI assigned

Oct 18, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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 1

Specialty

Clinical Social Worker

Education

University of Connecticut School of Medicine, 1964

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Country Community Mental HealthGroup PAC ID 8820052095, 18 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• North Country Community Mental Health

  • Community/Behavioral Health Agency
  • Petoskey, MI
  • NPI 1053474015
  Medicare reassignment Care Compare group
• Mid-Michigan Family, LTD.

  • Professional Counselor
  • Mount Pleasant, MI
  • NPI 1760550057
  NPD (past) Authorized official
• North Country Community Mental Health

  • Community/Behavioral Health Agency
  • Petoskey, MI
  • NPI 1881060549
  NPD (past)

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

{
    "created_epoch": "1350518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350518400000",
    "number": "1881947653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 E. WISCONSIN STREET",
            "city": "MOUNT PLEASANT",
            "state": "MI",
            "postal_code": "488582767",
            "telephone_number": "989-773-9600",
            "fax_number": "989-772-3387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 E. WISCONSIN STREET",
            "city": "MOUNT PLEASANT",
            "state": "MI",
            "postal_code": "488582767",
            "telephone_number": "989-773-9600",
            "fax_number": "989-772-3387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRAS",
        "first_name": "JOHN",
        "middle_name": "WILLIAM",
        "name_prefix": "Mr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-10-18",
        "last_updated": "2012-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": "6401000058",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801034726",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MI",
            "license": "4101005325",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carolyn Peters
• Joelle Sue Peters
• Leah Renee Peters
• Brooke A. Peterson
• Lyric Peterson
• David Petrella, M.D.
• Mary Phillips
• Adam Charles Philo, MA, LPC
• Physician Management Services of Michigan II, LLC
• Physiotherapy Associates Inc

• Social Worker in Mount Pleasant, MI
• Providers in Mount Pleasant, MI by specialty
• Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 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.
• 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.