Amy Petrillo, NP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

RN237354 Issued in GA

Practice address

663 Lanier Park Dr
Gainesville, GA 30501-2059

Phone

(678) 450-0202

Fax

(678) 450-0080

NPI assigned

Apr 21, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Kidney Care Center of Georgia LLCGroup PAC ID 9638200819, 24 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northside Hospital Forsyth Hospital, Cumming, GA, CCN 110005
• Emory Johns Creek Hospital Hospital, Johns Creek, GA, CCN 110230
• Northeast Georgia Medical Center, Inc Hospital, Gainesville, GA, CCN 110029

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations (25 of 30)

Interoperability endpoints

• Direct secure messaging: apetrillo64524@direct.acumenmd.com

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.

• Kidney Care Center of Georgia LLC

  • Nephrology Physician
  • Gainesville, GA
  • NPI 1588981187
  Medicare reassignment Care Compare group NPD

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

• Ehca Johns Creek, LLC

  dba Emory Johns Creek Hospital

  • General Acute Care Hospital
  • Johns Creek, GA
  • NPI 1679632137
  Care Compare affiliation
• Northeast Georgia Medical Center, Inc.

  • General Acute Care Hospital
  • Gainesville, GA
  • NPI 1427055821
  Care Compare affiliation
• Northside Hospital, Inc.

  dba Northside Hospital Forsyth

  • General Acute Care Hospital
  • Cumming, GA
  • NPI 1376574277
  Care Compare affiliation

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

{
    "created_epoch": "1650499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733184000000",
    "number": "1902540594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "663 LANIER PARK DR",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305012059",
            "telephone_number": "678-450-0202",
            "fax_number": "678-450-0080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "663 LANIER PARK DR",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305012059",
            "telephone_number": "678-450-0202",
            "fax_number": "678-450-0080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRILLO",
        "first_name": "AMY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-21",
        "last_updated": "2024-12-03",
        "certification_date": "2024-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "GA",
            "license": "RN237354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chance F Perry, AGACNP
• John William Perry, M.D.
• Sean O'Neil Perry, PA
• Kelly-Ann Peters, PA-C
• Kathryn E Peth, PHARMD
• Lacey Stockton Pfau, PA-C
• Truc Minh Pham, O.D.
• Pharmaceutical Specialties Inc (Psi)
• Donovan Philbrick, D.O.
• Rachel Philips, PT, DPT

• Acute Care Nurse Practitioner in Gainesville, GA
• Providers in Gainesville, GA by specialty
• Acute Care Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2024; 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.