Peter Perry, P.A.-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA9103649 Issued in FL

Practice address

1409 Kingsley Ave
Suite 6a
Orange Park, FL 32073-4537

Phone

(904) 264-7517

Fax

(904) 264-0015

NPI assigned

Apr 5, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Physicians Group Services PA

  • Family Medicine Physician
  • Orange Park, FL
  • NPI 1861440810
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502064000000",
    "number": "1003878026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7855 ARGYLE FOREST BLVD.",
            "address_2": "STE. 101",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322445597",
            "telephone_number": "904-282-6331",
            "fax_number": "904-282-4117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1409 KINGSLEY AVE",
            "address_2": "SUITE 6A",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734537",
            "telephone_number": "904-264-7517",
            "fax_number": "904-264-0015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "PETER",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-05",
        "last_updated": "2017-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9103649",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "293082000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maureen Perez, DPT
• Periodontal Specialists of North Florida
• Benjamin Ryan Perkins, DO
• Miriam Perkins, DO
• Jennifer Ann Perna, D.M.D
• Zachary Perry, OTR/L
• Perspectives Counseling of North East Florida, LLC
• Rona Briones Perszyk, M.A.
• Peter J. Pitocchi MD PA
• Alyssa J Peterson, ED.S.

• Medical Physician Assistant in Orange Park, FL
• Providers in Orange Park, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.