Rebecca D Perry, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

22328 Issued in WI

Practice address

400 W Glen St
Crandon, WI 54520-1355

Phone

(715) 478-3318

Fax

(715) 478-3255

NPI assigned

Sep 22, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.73753

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.

• Sokaogon Chippewa Community

  • Federally Qualified Health Center (FQHC)
  • Crandon, WI
  • NPI 1033115456
  NPD (past)

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

{
    "created_epoch": "1127347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336435200000",
    "number": "1023004223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 W GLEN ST",
            "city": "CRANDON",
            "state": "WI",
            "postal_code": "545201355",
            "telephone_number": "715-478-3318",
            "fax_number": "715-478-3255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W GLEN ST",
            "city": "CRANDON",
            "state": "WI",
            "postal_code": "545201355",
            "telephone_number": "715-478-3318",
            "fax_number": "715-478-3255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "REBECCA",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-22",
        "last_updated": "2012-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "22328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey D Nielsen, DDS
• Northwoods Behavioral Health Center, LLC
• Jasee Novak
• Audra A Olson, RPH
• Paul Linderud
• William R Pierre, OD TPA
• Gary M Pusateri, MD
• Robert Lee Quade, RN
• Kristen Radloff, FNP, APNP
• Katherine Richlen, RD

• Internal Medicine Physician in Crandon, WI
• Providers in Crandon, WI by specialty
• Internal Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.