Individual Healthcare Provider
Caitlin Amanda Petry, MSN, FNP-C
Provider's NPPES record last updated: November 27, 2024
Overview
- Entity Type
- Individual Healthcare Provider
- NPI
- 1205303948
- Primary Specialty
- Nurse Practitioner — Family
- Practice Location
- Saint Peters, Missouri
- Sole Proprietor
- No
Federal Screening
NPISignal checked this NPI against federal exclusion sources. Results below are based on the NPI number itself — an identifier match, not a name match.
List of Excluded Individuals/Entities (LEIE)
HHS Office of Inspector General
No potential match was identified in NPISignal's indexed List of Excluded Individuals/Entities (LEIE) records as of 2026-09-10.
- Source data
- September 10, 2026
- Records indexed
- 84,001
- Screened
- Sep 18, 2026, 10:10 AM UTC
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
SAM.gov Exclusions
U.S. General Services Administration
SAM.gov Exclusions was not checked.
SAM.gov screening is not configured on this deployment. No SAM check has been performed.
- Screened
- Not checked
This is an NPI-based check only. NPISignal does not publish name-based exclusion matches on a provider profile. A shared or similar name is a lead that requires human review, not an identification, and this page is not the place to make one. Run a name-based screening below to see potential matches with the reasons for each.
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
Searches OIG LEIE and SAM.gov by name and reviews every potential match.
Specialties & Taxonomies
- Primary
Nurse Practitioner
Family
Physician Assistants & Advanced Practice Nursing Providers
Definition to come...
Taxonomy code 363LF0000X Internal Medicine
Nephrology
Allopathic & Osteopathic Physicians
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
Taxonomy code 207RN0300XNurse Practitioner
Physician Assistants & Advanced Practice Nursing Providers
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
Taxonomy code 363L00000X
Provider-Reported License Information
- Nurse Practitioner (Missouri)
- 2019039233
- Internal Medicine (Missouri)
- 2018040229
- Nurse Practitioner (Missouri)
- 2018040229
- Nurse Practitioner (Illinois)
- 209025210
Practice Locations
Practice Location
400 Mid Rivers Mall Dr
Saint Peters, Missouri 63376-1577
Phone: (636) 279-1516
Additional Practice Location
1802 Elm St
Canton, Missouri 63435-1694
Phone: (573) 288-5360
Fax: (573) 288-5361
Additional Practice Location
211 S 3rd St
Louisiana, Missouri 63353-2000
Phone: (573) 754-5555
Fax: (573) 754-5932
Additional Practice Location
400 S Center St
Shelbina, Missouri 63468-1404
Phone: (573) 588-4131
Fax: (573) 588-4876
Additional Practice Location
6500 Hospital Dr
Hannibal, Missouri 63401-6890
Phone: (573) 629-3400
Fax: (573) 629-3314
Additional Practice Location
3650 Stardust Dr
Hannibal, Missouri 63401-2411
Phone: (573) 231-0660
Fax: (573) 231-0687
Additional Practice Location
821 Business Hwy 24 West
Monroe City, Missouri 63456
Phone: (573) 735-2506
Fax: (573) 735-1083
Record Information
- Enumeration Date
- October 31, 2018
- Provider's NPPES Record Last Updated
- November 27, 2024
- Certification Date
- November 27, 2024
- NPISignal NPPES Dataset
- August 2026
See Something Wrong?
Incorrect provider information
Everything on this page comes directly from the NPPES data CMS publishes. NPISignal cannot edit a provider's record — only the provider or organization can, directly through NPPES.
Update a record through NPPESSomething wrong with this page?
If NPISignal is displaying this data incorrectly — a formatting error, a broken link, a mismatch with the source file — let us know.
Report a display issue