Jaclyn M Perez, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

13518 Issued in TN

Practice address

800 Weatherly Dr
Ste 201
Clarksville, TN 37043-8957

Phone

(931) 648-1912

Fax

(931) 648-1277

NPI assigned

Aug 7, 2008

Sex

Female

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 TN

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

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jaclynperez@ncps.allscriptsdirect.net
• Direct secure messaging: jaclyn.perez@rkc.eclinicaldirectplus.com
• Direct secure messaging: jaclyn.perez.1@31800.direct.athenahealth.com

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.

• Crossroads Urgent Care PLLC

  • Family Medicine Physician
  • Murfreesboro, TN
  • NPI 1366644361
  Medicare reassignment NPD
• Crossroads Urgent Care PLLC

  • Rural Health Clinic/Center
  • South Pittsburg, TN
  • NPI 1427781129

  Family

  NPD
• Northcrest Physician Services Inc

  • Internal Medicine Physician
  • Springfield, TN
  • NPI 1356561856
  NPD
• Grace Pediatrics PLLC

  • Pediatrics Physician
  • Smyrna, TN
  • NPI 1467781690
  NPD (past)
• MCR Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Parrish, FL
  • NPI 1255376000

  Family

  NPD (past)

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

{
    "created_epoch": "1218067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365033600000",
    "number": "1174779375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 STONECREST PKWY",
            "address_2": "STE 210",
            "city": "SMYRNA",
            "state": "TN",
            "postal_code": "371676826",
            "telephone_number": "615-625-7112",
            "fax_number": "615-625-7028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 WEATHERLY DR",
            "address_2": "STE 201",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370438957",
            "telephone_number": "931-648-1912",
            "fax_number": "931-648-1277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "JACLYN",
        "middle_name": "M",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-07",
        "last_updated": "2013-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "13518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Desiree Pequeno
• Stephen H Percelay, MD
• Alexis Victoria Perez
• Gloria Faith Perez
• Iris Perez, RBT
• John Perez, RN
• Maeghan Perez
• Melissa Diane Perez
• Jacqueline Perkins
• Keith Lou Anthony Perkins Jr., M.D.

• Family Nurse Practitioner in Clarksville, TN
• Providers in Clarksville, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2013; 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.