NPIMap

Individual provider Active NPI

Terry Ray Perrine, MD

  • Family Medicine Physician
  • Tupelo, MS
National Provider Identifier
1033157391
Registry record updated Mar 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
17934 Issued in MS
Practice address
1665 S Green St
Tupelo, MS 38804-6556
Phone
(662) 377-2189
Fax
(662) 377-2263
NPI assigned
Jun 2, 2006
Last updated
Mar 19, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 17934 MS Primary

Addresses

Primary practice location

1665 S Green St
Tupelo, MS 38804-6556

Mailing address

450 E President Ave
Tupelo, MS 38801-5599
Phone (662) 377-4685

Other identifiers 1

IdentifierTypeStateIssuer
07122075MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100615000408 MS Practitioner - Family Practice 9234269424 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Virginia Commonwealth University, School of Medicine, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Mississippi Faculty Practice Plan LLCGroup PAC ID 2961658950, 8 clinicians

Practice addresses (Care Compare)

1665 S Green St
Tupelo, MS 38804-6556
Phone (662) 377-2189

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
North Mississippi Faculty Practice Plan LLC Family Medicine CurrentSince Jul 1, 2012 Accepting new patients
North Mississippi Medical Center Current Accepting new patients
North Mississippi Medical Center, Inc CurrentSince Sep 26, 2017 Accepting new patients
North Mississippi Medcial Center, Inc. CurrentSince Sep 26, 2017 Accepting new patients
North Mississippi Medical Center Inc Current Accepting new patients
South Hills Chiropractic, Inc. PastSince May 1, 2003 Accepting new patients
United Methodist Senior Services Health Care, Inc Past Accepting new patients
North Mississippi Medical Center, Inc. Past Accepting new patients
Tupelo Plastic Surgery Clinic of Tupelo PA Past Accepting new patients
North Mississippi Faculty Practice Family Medicine Past Accepting new patients

Locations

1665 S Green St
Tupelo, MS 38804
Phone (662) 377-2189

4381 S Eason Blvd
Ste 101
Tupelo, MS 38801
Phone (662) 377-4054

450 E President Ave
Tupelo, MS 38801
Phone (662) 377-3204

830 S Gloster St
Tupelo, MS 38801
Phone (662) 377-3136

Interoperability endpoints

  • Direct secure messaging: terryperrine@nmhs.medalliesdirect.net

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Cedars Health CenterTupelo, MS, CCN 255309 Skilled nursing facility Adp of the SNF Jan 1, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 10

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

Hospital & facility affiliations 6

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": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332115200000",
    "number": "1033157391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 E PRESIDENT AVE",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388015599",
            "telephone_number": "662-377-4685",
            "fax_number": "662-377-2755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1665 S GREEN ST",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388046556",
            "telephone_number": "662-377-2189",
            "fax_number": "662-377-2263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRINE",
        "first_name": "TERRY",
        "middle_name": "RAY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2012-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "17934",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07122075",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tupelo, MS

Sources for this page

Verify at the official NPI Registry.