JANIS PETRIE (NPI# 1134283096) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134283096 |
| Entity Type | Individual |
| Full Name | JANIS PETRIE |
| Credential | ARNP |
| Practice Address |
48844 Highway 101 Bandon OR 97411-8232 |
| Practice Telephone | 5413292078 |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2016-04-03 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 1335053052 | KS | Nursing Service Providers |
| N | 163W00000X | Registered Nurse | 45275 | KS | Nursing Service Providers |
| N | 163WC1500X |
Registered Nurse Specialization: Community Health |
200440305RN | OR | Nursing Service Providers |
| Y | 163WP0808X |
Registered Nurse Specialization: Psych/Mental Health |
74552 | KS | Nursing Service Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
200450014NP | OR | Physician Assistants & Advanced Practice Nursing Providers |
| N | 364SP0808X |
Clinical Nurse Specialist Specialization: Psych/Mental Health |
201070011C | OR | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | PTAN | R164226 | 01 |
| Street Address |
48844 HIGHWAY 101 |
| City | BANDON |
| State | OR |
| Zip Code | 97411-8232 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851756340 | Carl John Moehring | Internal Medicine | 2840 Beach Loop Dr. Sw, Bandon, OR 97411 | 2015-12-28 |
| 1841692969 | Bandon Senior Living LLC | Assisted Living Facility | 1000 6th Ave West, Bandon, OR 97411 | 2014-09-19 |
| 1962824821 | Oregon Retina, LLP | Ophthalmology | 1095 Alabama Street, Bandon, OR 97411 | 2014-01-13 |
| 1063756401 | Bandon Coastal Dental, LLC | Clinic/Center | 1097 Baltimore Ave, Bandon, OR 97411 | 2012-11-26 |
| 1114205028 | James Ryan Surface | Dentist | 1275 Oregon Ave., Bandon, OR 97411 | 2011-07-26 |
| 1790083509 | William M. Soper, Dds | Preferred Provider Organization | 1275 Oregon Ave, Bandon, OR 97411 | 2011-03-02 |
| 1285860635 | Sharen C. Strong | Dentist | 155 Delaware Ave, Bandon, OR 97411 | 2009-05-29 |
| 1518158500 | Coos Eye Centers, Inc. | Optometrist | 1095 Alabama Avenue, Bandon, OR 97411 | 2007-08-06 |
| 1043432040 | Michael Brent Currie | Chiropractor | 55416 Melton Road, Bandon, OR 97411 | 2007-05-02 |
| 1619098167 | Susan Lynn Dimock | Social Worker | 1212 Alabama St, Suite 27, Bandon, OR 97411 | 2007-04-03 |
| Find all providers in zip 97411 | ||||
| Taxonomy Code | 163WP0808X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932747607 | Kendall Clayton Karch | Registered Nurse | 30 Ne Mlk Jr Blvd, Portland, OR 97232-2941 | 2019-12-12 |
| 1003315045 | Ryan Tateishi | Registered Nurse | 966 12th St Se Ste 110, Salem, OR 97302-2860 | 2018-02-05 |
| 1952815532 | Shane Martin | Registered Nurse | 2110 Augusta St, Eugene, OR 97403-2202 | 2017-11-19 |
| 1811349160 | Aleksey Maksimov | Registered Nurse | 4757 Parkview Dr Apt B, Lake Oswego, OR 97035-2426 | 2016-07-11 |
| 1366832461 | Maria Liotta Shindler | Registered Nurse | 6201 Ne Carillion Dr, Hillsboro, OR 97124-8590 | 2015-01-27 |
| 1346651882 | Holly Marie Matthews | Registered Nurse | 788 Saint Charles Pl, Hood River, OR 97031-8785 | 2014-05-19 |
| 1376987404 | Helen Erika Horst | Registered Nurse | 2020 State Rd, Mosier, OR 97040 | 2013-04-19 |
| 1598013997 | Trina Marie Espiasse | Registered Nurse | 47940 Sw Ihrig Rd, Forest Grove, OR 97116-7329 | 2012-08-16 |
| 1275810665 | Esther Gabrielle Rosengarten | Registered Nurse | 1020 Sw Taylor St Ste 745, Portland, OR 97205-2505 | 2011-11-14 |
| 1336436823 | Susan Elizabeth Stone | Registered Nurse | 19333 Sw Laurelhurst Way, Bend, OR 97702-3192 | 2011-07-05 |
| Find all providers with the same taxonomy | ||||
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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.