Active NPI
Joseph A Petrozza, MD
- Gastroenterology Physician
- Statesville, NC
National Provider Identifier
1992796320
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 27505
- Practice address
- 740 Bryant St
Statesville, NC 28677-4143 - Phone
- (704) 873-7330
- NPI assigned
- Nov 3, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 27505 | NC | Primary |
Addresses
Primary practice location
740 Bryant St
Statesville, NC 28677-4143
Mailing address
650 Signal Hill Drive Ext
PO Box 1845
Statesville, NC 28625-4353
Phone (704) 873-4277
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8967231 | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27505 | NC | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
Interoperability endpoints
- josephpetrozza@phc.allscriptsdirect.net
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130976000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1201219200000",
"number": "1992796320",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "650 SIGNAL HILL DRIVE EXT",
"address_2": "PO BOX 1845",
"city": "STATESVILLE",
"state": "NC",
"postal_code": "286254353",
"telephone_number": "704-873-4277",
"fax_number": "704-873-4511"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "740 BRYANT ST",
"city": "STATESVILLE",
"state": "NC",
"postal_code": "286774143",
"telephone_number": "704-873-7330"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETROZZA",
"first_name": "JOSEPH",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-03",
"last_updated": "2008-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "NC",
"license": "27505",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8967231",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Statesville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 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.