Individual provider Active NPI

Kami Alyss Perry, CRNP

  • Family Nurse Practitioner
  • Birmingham, AL
National Provider Identifier
1053183376
Registry record updated Oct 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-139707 Issued in AL
Practice address
216 Aquarius Dr Ste 306
Birmingham, AL 35209-5863
Phone
(205) 949-0400
NPI assigned
Oct 30, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2023

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 1-139707 AL Primary

Addresses

Primary practice location

216 Aquarius Dr Ste 306
Birmingham, AL 35209-5863

Mailing address

11664 Chigger Ridge Rd
Brookwood, AL 35444-0719
Phone (205) 470-1110

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20240207000222 AL Practitioner - Nurse Practitioner 9335582337 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gastrocare PCGroup PAC ID 4981687712, 5 clinicians

Practice addresses (Care Compare)

120 Rice Mine Rd N
Tuscaloosa, AL 35406-3901
Phone (205) 752-1175

Hospital & facility affiliations

National Provider Directory

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

Organizations & group practices 1

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 3

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": "1698624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698624000000",
    "number": "1053183376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11664 CHIGGER RIDGE RD",
            "city": "BROOKWOOD",
            "state": "AL",
            "postal_code": "354440719",
            "telephone_number": "205-470-1110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 AQUARIUS DR STE 306",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352095863",
            "telephone_number": "205-949-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "KAMI",
        "middle_name": "ALYSS",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-30",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-139707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.