AMY VIOLA PETRIE (NPI# 1649386319) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649386319 |
| Entity Type | Individual |
| Full Name | AMY VIOLA PETRIE |
| Credential | PAC |
| Practice Address |
2002 S 11th St Niles MI 49120-4074 |
| Mailing Address |
6416 Deans Hill Rd Berrien Center MI 49102-9750 |
| Practice Telephone | 2696870200 |
| Practice Fax Number | 2696840199 |
| Mailing Telephone | 2694717741 |
| Mailing Fax Number | 2694711581 |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2013-03-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
5601006305 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
085002713 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 1649386319 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700071495 | Amy Lynn Petrie | Licensed Practical Nurse | 30951 Poole Rd, Theresa, NY 13691-2234 | 2007-09-06 |
| 1154546000 | Amy R Petrie | Obstetrics & Gynecology | 5800 Heritage Landing Dr, Suite C, East Syracuse, NY 13057-9378 | 2007-04-16 |
| Street Address |
2002 S 11TH ST |
| City | NILES |
| State | MI |
| Zip Code | 49120-4074 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265478192 | Daniel M Metzger | Specialist | 2002 S 11th St, Niles, MI 49120-4074 | 2006-06-20 |
| 1922621556 | Angela Coleman | Nurse Practitioner | 2002 S 11th St, Niles, MI 49120-4074 | 2020-05-18 |
| 1861988180 | Carrie Lozmack | Nurse Practitioner | 2002 S 11th St, Niles, MI 49120-4074 | 2018-07-10 |
| 1275988867 | Joan Madsen | Nurse Practitioner | 2002 S 11th St, Niles, MI 49120-4074 | 2016-05-02 |
| 1174984413 | Amanda Leigh Mills | Nurse Practitioner | 2002 S 11th St, Niles, MI 49120-4074 | 2016-03-15 |
| 1538592753 | Lakeland Community Hospital Watervliet | Clinic/Center | 2002 S 11th St, Niles, MI 49120-4074 | 2013-08-12 |
| 1164764155 | Jennifer Ann Layman-young | Nurse Practitioner | 2002 S 11th St, Niles, MI 49120-4074 | 2013-03-18 |
| 1083960652 | Lauren-shylene Luna Toscano | Nurse Practitioner | 2002 S 11th St, Niles, MI 49120-4074 | 2012-08-01 |
| 1124394945 | Elizabeth Ann Mcglothlin | Family Medicine | 2002 S 11th St, Niles, MI 49120-4074 | 2012-03-26 |
| 1548588031 | Lakeland Medical Practices | Clinic/Center | 2002 S 11th St, Niles, MI 49120-4074 | 2010-05-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093285652 | The Caerus Group LLC | Clinic/Center | 732 S. 11th St #197, Niles, MI 49120 | 2018-11-27 |
| 1306316971 | Vicki L Yarbro | Physical Therapist | 6 Longmeadow Village Dr. Suite 3, Niles, MI 49120 | 2018-11-27 |
| 1063831469 | Aaron Joseph Lanning | Nurse Practitioner | 42 N Saint Joseph Ave Ste 300, Niles, MI 49120 | 2014-04-14 |
| 1740601186 | Terrianne Klaeren | Occupational Therapist | 1009 Almaugus Drive, Niles, MI 49120 | 2014-01-03 |
| 1124469366 | All Needs Senior Services, Inc. | Home Health | 1723 Pucker Street Dr, Suite A, Niles, MI 49120 | 2013-07-16 |
| 1902105034 | Nile Family Pharmacy LLC | Pharmacy | 70 E. State St., Niles, MI 49120 | 2011-03-15 |
| 1629240734 | Karen L Palmer | Counselor | 115 S St Joseph Ave, Niles, MI 49120 | 2008-03-28 |
| 1124218391 | Melissa A Longley | Social Worker | 333 N. Second Street, Suite 303, Niles, MI 49120 | 2007-07-25 |
| 1841410727 | Periza Zaninovic | Dentist | 123 Marmont Street, Niles, MI 49120 | 2007-04-26 |
| 1477629087 | Stephen Williams Tankersley | Dentist | 226 S Lincoln Ave, Niles, MI 49120 | 2006-11-27 |
| Find all providers in zip 49120 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538705272 | Bethany Mae Frisby | Physician Assistant | 8630 W Golf Rd, Niles, IL 60714-5600 | 2019-11-18 |
| 1265608780 | Jeffrey Thomas Walsh | Physician Assistant | 918 Youngstown Warren Rd Ste C, Niles, OH 44446-4623 | 2008-05-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023616687 | Alexandria Jaclyn Miller | Physician Assistant | 4700 Chipman Dr, Waterford, MI 48327-3413 | 2020-10-15 |
| 1639777287 | Piotr Z Purzycki | Physician Assistant | 41400 Dequindre Rd Ste 101, Sterling Heights, MI 48314-3751 | 2020-10-15 |
| 1013524859 | Amber Marie Lee | Physician Assistant | 2265 South Lindenroad, Suite A, Flint, MI 48532 | 2020-09-25 |
| 1326656844 | Dominic Farrell | Physician Assistant | 224 Portchester Rd, Holland, MI 49424-2628 | 2020-07-21 |
| 1982212072 | Alexandria Bower-nelson | Physician Assistant | 1302 Porter Drive, Charlotte, MI 48813 | 2020-07-15 |
| 1013535343 | Maria Pavia | Physician Assistant | 41302 Scarborough Ln, Novi, MI 48375-2893 | 2020-07-13 |
| 1073130241 | Kelly F Esper | Physician Assistant | 9043 Glenwood Ln, Northville, MI 48168-9129 | 2020-07-02 |
| 1811513971 | Tasha Baker | Physician Assistant | 5444 E Whitefeather Rd, Pinconning, MI 48650-8407 | 2020-06-24 |
| 1437770054 | Sterling Ryan Maxfield | Physician Assistant | 6187 Oak Grove Rd, Howell, MI 48855-8247 | 2020-05-05 |
| 1760018808 | Rachel Renee Mackmin | Physician Assistant | 41498 Mary Kay Dr, Clinton Township, MI 48038-1989 | 2020-03-20 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.