Individual provider Active NPI

Melissa Darlene Perez, NP-C

  • Family Nurse Practitioner
  • Teague, TX
National Provider Identifier
1124791892
Registry record updated Jul 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1048620 Issued in TX
Practice address
101 Anthony Dr
Teague, TX 75860-1000
Phone
(903) 388-2464
NPI assigned
Jul 28, 2021
Last updated
Jul 28, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2021

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 1048620 TX Primary

Addresses

Primary practice location

101 Anthony Dr
Teague, TX 75860-1000

Mailing address

301 S Avenue B
Wortham, TX 76693-4646
Phone (903) 388-2464

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20211019000398 TX Practitioner - Nurse Practitioner 4486042777 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

101 Anthony Dr
Teague, TX 75860-1000
Phone (254) 739-5655

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1048620TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mexia Principal Healthcare Limited Partnership CurrentSince Oct 1, 2021 Accepting new patients
Mexia Principal Healthcare Limited Partnership Current Accepting new patients
Mexia Principal Healthcare Limited Partnership CurrentSince Oct 1, 2021 Accepting new patients
Mexia Principal Healthcare Limited Partnership Past Accepting new patients

Locations

330 Seven Springs Way
Brentwood, TN 37027
Phone (615) 920-7780

514 S Bonham St
Mexia, TX 76667
Phone (254) 562-9321

514 S Bonham St
Ste G
Mexia, TX 76667
Phone (254) 562-9321

600 S Bonham St
Mexia, TX 76667
Phone (254) 562-5332

101 Anthony Dr
Teague, TX 75860
Phone (254) 739-5655

Interoperability endpoints

  • Direct secure messaging: melissa.perez.1@20210.direct.athenahealth.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1627430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627430400000",
    "number": "1124791892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 S AVENUE B",
            "city": "WORTHAM",
            "state": "TX",
            "postal_code": "766934646",
            "telephone_number": "903-388-2464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 ANTHONY DR",
            "city": "TEAGUE",
            "state": "TX",
            "postal_code": "758601000",
            "telephone_number": "903-388-2464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "MELISSA",
        "middle_name": "DARLENE",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-28",
        "last_updated": "2021-07-28",
        "certification_date": "2021-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1048620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Teague, TX

Sources for this page

Verify at the official NPI Registry.