Brock Petri

Primary specialty

Electroneurodiagnostic Specialist/TechnologistTaxonomy code 246ZE0600X

Practice address

4515 S McClintock Dr
Tempe, AZ 85282-7376

Phone

(480) 229-5309

NPI assigned

Nov 20, 2017

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1511136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511136000000",
    "number": "1962916429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 S OAK CIR",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852264477",
            "telephone_number": "480-229-5309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4515 S MCCLINTOCK DR",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852827376",
            "telephone_number": "480-229-5309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRI",
        "first_name": "BROCK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-11-20",
        "last_updated": "2017-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZE0600X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Electroneurodiagnostic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Ryan Peterson, ARNP
• Kathleen E Peterson, DOCTOR OF AUDIOLOGY
• Leslie Peterson, LPC
• Robin Peterson
• Michael M Petkovic, OT
• Bridget Nester Petrillo, CRNA
• Elizabeth Petrissans, CCC-SLP
• Stephanie Petroff, RBT
• Peter Petrov, PHARMD
• Lori Petterson, OTR/L, CDMS

• Electroneurodiagnostic Specialist/Technologist in Tempe, AZ
• Providers in Tempe, AZ by specialty
• Electroneurodiagnostic Specialist/Technologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2017; 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.