Kyle Petrina, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CHIR010201 Issued in GA

Practice address

2095 Highway 211 NW Ste 3a
Braselton, GA 30517-3403

Phone

(678) 710-3011

NPI assigned

May 6, 2019

Sex

Male

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

Enrolled in GA

Enrollment records 1

Specialty

Chiropractic

Education

Other, 2019

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Petrina Chiropractic

  • Chiropractor
  • Braselton, GA
  • NPI 1083303093
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1557100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647993600000",
    "number": "1922663970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "267 BRIGHTON PARK CIR",
            "city": "HOSCHTON",
            "state": "GA",
            "postal_code": "305483153",
            "telephone_number": "770-689-6399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2095 HIGHWAY 211 NW STE 3A",
            "city": "BRASELTON",
            "state": "GA",
            "postal_code": "305173403",
            "telephone_number": "678-710-3011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRINA",
        "first_name": "KYLE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-05-06",
        "last_updated": "2022-03-23",
        "certification_date": "2022-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR010201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Peck, DPT
• Samhitha Peddada, MD
• Shanthan Pendem, MD
• Diego Perez, FNP
• Petrina Chiropractic
• Kelly Pierannunzi, FNP-C
• Lindsay Hale Pinion, PA-C
• Lydia Piutau, CSW
• Kalianna Marie Pivett, PA
• Plumeria Wellness, LLC

• Chiropractor in Braselton, GA
• Providers in Braselton, GA by specialty
• Chiropractor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.