Patricia Ann Petrillo, RD,LDN

Primary specialty

Renal Nutrition Registered DietitianTaxonomy code 133VN1005X

License

LDN00425 Issued in RI

Practice address

1076 N Main St
Providence, RI 02904-5760

Phone

(401) 861-7711

Fax

(401) 421-5710

NPI assigned

Mar 7, 2008

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1204848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204848000000",
    "number": "1912177734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 BISHOP HILL RD",
            "city": "JOHNSTON",
            "state": "RI",
            "postal_code": "029192821",
            "telephone_number": "401-764-0124",
            "fax_number": "401-764-0124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1076 N MAIN ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029045760",
            "telephone_number": "401-861-7711",
            "fax_number": "401-421-5710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRILLO",
        "first_name": "PATRICIA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "RD,LDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-07",
        "last_updated": "2008-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1005X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Renal",
            "state": "RI",
            "license": "LDN00425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenna Petitt, DPT
• Jessica Petrangelo
• Kirsten Ann Petrarca, AUD
• Ariana Marie Petrella, CNM
• Diane Marie Petrella, MSW
• Sara Pingul Petrillo II, MD
• Christiane Petrin Lambert, LICSW
• Courtney Lynn Petrin, B.A
• Gianna Petrone, DO
• Nerses Petrosyan, MD

• Renal Nutrition Registered Dietitian in Providence, RI
• Providers in Providence, RI by specialty
• Renal Nutrition Registered Dietitian in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.