Gary Charles Perez, PHYSICIAN ASSISTANT

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA 9103949 Issued in FL

Practice address

550 Redstone Ave W
Suite 370
Crestview, FL 32536-6428

Phone

(850) 682-2209

Fax

(850) 850-6822

NPI assigned

Aug 5, 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

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• North Okaloosa Clinic Corp

  • Durable Medical Equipment & Medical Supplies
  • Crestview, FL
  • NPI 1477738896
  NPD (past)
• Panhandle Orthopaedics LLC

  • Orthopaedic Surgery Physician
  • Pensacola, FL
  • NPI 1902850258

  Physician Assistant

  NPD (past)

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

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328745600000",
    "number": "1154512358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 REDSTONE AVE W",
            "address_2": "SUITE 370",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325366428",
            "telephone_number": "850-682-2209",
            "fax_number": "850-850-6822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 REDSTONE AVE W",
            "address_2": "SUITE 370",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325366428",
            "telephone_number": "850-682-2209",
            "fax_number": "850-850-6822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "GARY",
        "middle_name": "CHARLES",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-05",
        "last_updated": "2012-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA 9103949",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002879600",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA LICENSE",
            "identifier": "PA9103949",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1467589010",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID MEDICARE GROUP",
            "identifier": "592921954",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NPI GROUP",
            "identifier": "1467589010",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Haley Rebecca Paulk, PT, DPT
• Pax Cardiovascular Specialists LLC
• Peachy Orchard LLC
• Tonie Lyn Peasley, OTR/L
• Pensacola Nephrology, PA
• Sherry Nicole Perez
• Performance Prosthetics & Orthotics, PL
• Samaria Perkins
• Brittany Perry
• Natasha Nicole Perry, M.A.

• Physician Assistant in Crestview, FL
• Providers in Crestview, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2012; 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.