Corporate Lakes Urology, LLC

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

0431342 Issued in KS

Legal business name

CORPORATE LAKES UROLOGY, LLC

Practice address

6740 W 121St St
Suite 350
Overland Park, KS 66209-2002

Phone

(913) 948-8365

Fax

(913) 541-1034

NPI assigned

Apr 6, 2016

Last updated

Apr 6, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Billy Burl Perry, M.D.NPI 1598731267

Title

Owner

Phone

(913) 948-8365

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KS

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/16345/brand/1/csg/1/fhir/r4

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Billy B. Perry, M.D.

  • Urology Physician
  • Overland Park, KS
  • NPI 1598731267
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1459900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459900800000",
    "number": "1124482187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6740 W 121ST ST",
            "address_2": "SUITE 350",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662092002",
            "telephone_number": "913-948-8365",
            "fax_number": "913-541-1034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6740 W 121ST ST",
            "address_2": "SUITE 350",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662092002",
            "telephone_number": "913-948-8365",
            "fax_number": "913-541-1034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORPORATE LAKES UROLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-06",
        "last_updated": "2016-04-06",
        "status": "A",
        "authorized_official_last_name": "PERRY",
        "authorized_official_first_name": "BILLY",
        "authorized_official_middle_name": "BURL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "913-948-8365",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "KS",
            "license": "0431342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Urology Physician in Overland Park, KS
• Providers in Overland Park, KS by specialty
• Urology Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.