Nelson R Perez, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

117744 Issued in MO

Practice address

304 Teaco Rd
Suite G
Kennett, MO 63857-3266

Phone

(573) 888-4370

NPI assigned

Jan 20, 2007

Sex

Male

Sole proprietor

No

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.

• Southeast Missouri Health Network

  • Federally Qualified Health Center (FQHC)
  • New Madrid, MO
  • NPI 1609095975

  MO

  Medicare reassignment Care Compare group NPD
• Mercy Clinic Springfield Communities

  • Family Medicine Physician
  • Springfield, MO
  • NPI 1245277631

  MO

  Medicare reassignment NPD
• Southeast Missouri Health Network

  • Federally Qualified Health Center (FQHC)
  • New Madrid, MO
  • NPI 1790531119
  Care Compare group NPD
• Southeast Missouri Health Network

  • Federally Qualified Health Center (FQHC)
  • Sikeston, MO
  • NPI 1134340102
  Care Compare group
• Southeast Missouri Health Network

  • Federally Qualified Health Center (FQHC)
  • Bernie, MO
  • NPI 1194945154
  Care Compare group
• Southeast Missouri Health Network

  • Federally Qualified Health Center (FQHC)
  • Benton, MO
  • NPI 1497035661
  Care Compare group
• Southeast Missouri Health Network

  • Federally Qualified Health Center (FQHC)
  • Sikeston, MO
  • NPI 1619513215
  Care Compare group
• Southeast Missouri Health Network

  • Federally Qualified Health Center (FQHC)
  • Caruthersville, MO
  • NPI 1649697566
  Care Compare group
• Southeast Missouri Health Network

  • Federally Qualified Health Center (FQHC)
  • Kennett, MO
  • NPI 1710108766
  Care Compare group
• Southeast Missouri Health Network

  • Federally Qualified Health Center (FQHC)
  • Sikeston, MO
  • NPI 1104045475
  NPD
• Missouri Delta Medical Center

  • General Acute Care Hospital
  • Sikeston, MO
  • NPI 1831269539
  NPD (past)

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

• Missouri Delta Medical Center

  • General Acute Care Hospital
  • Sikeston, MO
  • NPI 1831269539

  Hospital

  Care Compare affiliation

Specialty

Obstetrics/Gynecology

Education

University of Puerto Rico School of Medicine, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southeast Missouri Health Network 19 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Missouri Delta Medical Center Hospital, Sikeston, MO, CCN 260113

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nelson.perez.1@14764.direct.athenahealth.com

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1169251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043363005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1217 PINTAIL CV",
            "city": "KENNETT",
            "state": "MO",
            "postal_code": "638573833",
            "telephone_number": "573-888-4775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 TEACO RD",
            "address_2": "SUITE G",
            "city": "KENNETT",
            "state": "MO",
            "postal_code": "638573266",
            "telephone_number": "573-888-4370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "NELSON",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MO",
            "license": "117744",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "136782001",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "203904503",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sharon Ann Payne, FNP-C
• Allison Ann Peck, RN
• Jerris Jean Pelts
• Pemiscot County Memorial Hospital
• Pemiscot County Memorial Hospital
• Chandra Celeste Perkins-Shannon
• Legusta Renee Perkins
• Angela Peters
• Elaina Danielle Phelps
• Heather Pickard

• All providers in Kennett, MO
• Obstetrics & Gynecology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.