ELLEN PETRYNA
NPI 1396208807
Student in an Organized Health Care Education/Training Program in Charlotte, NC

Q: What is Ellen Petryna's NPI number?

The NPI number for Ellen Petryna is 1396208807. It was assigned to this individual provider in the NPPES registry on April 11, 2019.

Q: What is Ellen Petryna's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Ellen Petryna was last updated on June 12, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 11, 2019PECOS Enrolled

1000 BLYTHE BLVD, CHARLOTTE, NC 28203(704) 355-2000 Get Directions Write a Review

NPPES record last updated: June 12, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 12, 2023, Apr 11, 2019 (2 updates tracked since 2019).

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About Ellen Petryna NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ELLEN PETRYNA (NPI 1396208807) is an individual student in an organized health care education/training program in Charlotte, North Carolina and active in the NPI registry since April 2019. She is enrolled in Medicare PECOS and maintains a secondary practice location in Memphis.

NPPES Registry Identity

NPI1396208807

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameELLEN PETRYNA

Location Address1000 BLYTHE BLVDCharlotte, NC 28203-5812

Mailing Address1000 Blythe BlvdCharlotte, NC 28203-5812 · (704) 355-2000

Phone(704) 355-2000

Sole ProprietorNo

Enumeration DateApril 11, 2019

Last NPPES UpdateJune 12, 20232 updates tracked since enumeration

NPPES CertifiedJune 12, 2023

✔ NPI 1396208807 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

1000 BLYTHE BLVD, Charlotte, NC 28203

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Secondary Practice Location 1

Location 1920 Madison Ave Ste 447Memphis, TN 38103-3438 · Phone (901) 448-5814

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ellen Petryna is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JENNIFER EGAN M.D.

Pathology (Clinical Pathology/Laboratory Medicine)