Individual provider Active NPI

Kamley Peralte

  • Health Maintenance Organization
  • Raleigh, NC
National Provider Identifier
1073973053
Registry record updated Mar 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
License
A5622 Issued in NC
Practice address
6421 Virgilia CT
Raleigh, NC 27616-3170
Phone
(646) 382-3053
NPI assigned
Mar 3, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X A5622 NC Primary

Addresses

Primary practice location

6421 Virgilia CT
Raleigh, NC 27616-3170

Mailing address

6421 Virgilia CT
Raleigh, NC 27616-3170

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

State licenses

LicenseStateTypeSpecialty
A5622NCMDHealth Maintenance Organization

NPI Registry JSON

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

{
    "created_epoch": "1456963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456963200000",
    "number": "1073973053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6421 VIRGILIA CT",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276163170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6421 VIRGILIA CT",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276163170",
            "telephone_number": "646-382-3053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERALTE",
        "first_name": "KAMLEY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-03-03",
        "last_updated": "2016-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "NC",
            "license": "A5622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.