John Thomas Pericles, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MB58296 Issued in NJ

Practice address

801 Boardwalk
Whole Health Wellness Center
Atlantic City, NJ 08401-7509

Phone

(609) 343-4003

Fax

(609) 343-4006

NPI assigned

Feb 15, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DE

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1144363250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 MORRIS AVE",
            "city": "EGG HARBOR TWP",
            "state": "NJ",
            "postal_code": "082348521",
            "telephone_number": "609-927-0554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 BOARDWALK",
            "address_2": "WHOLE HEALTH WELLNESS CENTER",
            "city": "ATLANTIC CITY",
            "state": "NJ",
            "postal_code": "084017509",
            "telephone_number": "609-343-4003",
            "fax_number": "609-343-4006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERICLES",
        "first_name": "JOHN",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "MB58296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Urmil Patel
• Yesha Nitang Patel
• PCR Health Center
• Raymond Pearson
• Magnolia M Pelaez, D.D.S.
• Peter Thompson, M.D., LLC
• Jeanmarie Petersen, DO
• Casey Alicia Peterson, NP-C
• Hemanth K Reddy Pethari, MD
• Scott Phillips

• Family Medicine Physician in Atlantic City, NJ
• Providers in Atlantic City, NJ by specialty
• Family Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.