Active NPI
Cheryl Marie Perera Beverly
- Clinical Social Worker
- Austin, TX
National Provider Identifier
1134624166
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 58958
- Practice address
- 2211 S Interstate 35 Ste 103
Austin, TX 78741-3842 - Phone
- (512) 766-3627
- Fax
- (512) 777-2801
- NPI assigned
- Mar 30, 2018
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 58958 | TX | Primary |
Addresses
Primary practice location
2211 S Interstate 35 Ste 103
Austin, TX 78741-3842
Mailing address
2211 S Interstate 35 Ste 103
Austin, TX 78741-3842
Phone (512) 766-3627
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 58958 | TX | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gramercy Specialty Clinic PLLC | Clinical | Past | Accepting new patients |
| Gramercy Specialty Clinic | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Professional Counselor
- Austin, TX
- NPI 1780051623
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1522368000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1522368000000",
"number": "1134624166",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2211 S INTERSTATE 35 STE 103",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787413842",
"telephone_number": "512-766-3627",
"fax_number": "512-777-2801"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2211 S INTERSTATE 35 STE 103",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787413842",
"telephone_number": "512-766-3627",
"fax_number": "512-777-2801"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PERERA BEVERLY",
"first_name": "CHERYL",
"middle_name": "MARIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-03-30",
"last_updated": "2018-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "58958",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.