Active NPI
John Perez, RN
- Registered Nurse
- Clarksville, TN
National Provider Identifier
1073235388
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 201202
- Practice address
- 782 Weatherly Dr
Clarksville, TN 37043-8941 - Phone
- (931) 645-3552
- NPI assigned
- Sep 13, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 201202 | TN | Primary |
Addresses
Primary practice location
782 Weatherly Dr
Clarksville, TN 37043-8941
Mailing address
719 Backwind LN
Clarksville, TN 37040-0601
Phone (931) 302-5821
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 201202 | TN | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1663027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663027200000",
"number": "1073235388",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "719 BACKWIND LN",
"city": "CLARKSVILLE",
"state": "TN",
"postal_code": "370400601",
"telephone_number": "931-302-5821"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "782 WEATHERLY DR",
"city": "CLARKSVILLE",
"state": "TN",
"postal_code": "370438941",
"telephone_number": "931-645-3552"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEREZ",
"first_name": "JOHN",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-09-13",
"last_updated": "2022-09-13",
"certification_date": "2022-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "TN",
"license": "201202",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Clarksville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.