Individual provider Active NPI

Anna Kate Perry, NP

  • Family Nurse Practitioner
  • Bolivar, TN
National Provider Identifier
1013883610
Registry record updated Oct 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
40039 Issued in TN
Practice address
622 W Market St
Bolivar, TN 38008-2201
Phone
(731) 422-0213
Fax
(731) 256-7628
NPI assigned
Oct 13, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 40039 TN Primary

Addresses

Primary practice location

622 W Market St
Bolivar, TN 38008-2201

Mailing address

PO Box 400
Jackson, TN 38302-0400
Phone (731) 425-5752

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251111003890 TN Practitioner - Nurse Practitioner 6406347004 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jackson Clinic PAGroup PAC ID 2668376872, 171 clinicians

Practice addresses (Care Compare)

622 W Market St
Bolivar, TN 38008-2241
Phone (731) 658-2885

Hospital & facility affiliations

  • West Tennessee Healthcare Bolivar Hospital Hospital, Bolivar, TN, CCN 441320

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
40039TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson Clinic PA CurrentSince Nov 1, 2025 Accepting new patients
Jackson Clinic PA CurrentSince Nov 1, 2025 Accepting new patients

Locations

622 W Market St
Bolivar, TN 38008
Phone (731) 658-2885

87 Murray Guard Dr
Ste B
Jackson, TN 38305
Phone (731) 664-1375

Interoperability endpoints

  • Direct secure messaging: annaperry@jcpa.allscriptsdirect.net

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1760313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760313600000",
    "number": "1013883610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 400",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383020400",
            "telephone_number": "731-425-5752",
            "fax_number": "731-256-7634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 W MARKET ST",
            "city": "BOLIVAR",
            "state": "TN",
            "postal_code": "380082201",
            "telephone_number": "731-422-0213",
            "fax_number": "731-256-7628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "ANNA",
        "middle_name": "KATE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-13",
        "last_updated": "2025-10-13",
        "certification_date": "2025-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "40039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bolivar, TN

Sources for this page

Verify at the official NPI Registry.