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KELLI A PETRONIS M.D. NPI 1083661151


NPI Information

NPI: 1083661151
Provider Name: KELLI A PETRONIS, M.D.
Classification: Pediatrics - 2080P0204X
Entity Type: Individual

Specialization: Pediatric Emergency Medicine

PECOS Registration: Yes

Address:
601 CHILDRENS LN
NORFOLK, VA
ZIP 23507
Phone: (757) 668-9222
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Kelli A Petronis, M.D. is a pediatric emergency medicine pediatrics in Norfolk, VA. The provider is a pediatrician who has special qualifications to manage emergencies in infants and children. Kelli A Petronis, M.D. NPI is 1083661151. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

601 CHILDRENS LN
NORFOLK, VA
ZIP 23507-910
Phone: (757) 668-9222
Fax: (757) 668-7568

The NPI 1083661151 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/27/2006 and was last updated on 6/28/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207L00000XAnesthesiology0101233589VIRGINIANo
2207PP0204XEmergency MedicinePediatric Emergency Medicine0101233589VIRGINIANo
3208000000XPediatrics0101233589VIRGINIANo
42080P0204XPediatricsPediatric Emergency Medicine0101233589VIRGINIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1006739105MEDICAIDVIRGINIA
21010661080001MEDICAIDPENNSYLVANIA
389066C4MEDICAIDNORTH CAROLINA
4403654900MEDICAIDMARYLAND

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.