Jordan Trace Perkins, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

2021021646 Issued in MO

Practice address

1008 S Spring Ave
Saint Louis, MO 63110-2520

Phone

(314) 977-1642

Fax

(314) 977-1642

NPI assigned

May 28, 2019

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1559001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623628800000",
    "number": "1184281909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1402 S GRAND BLVD # M260",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041004",
            "telephone_number": "314-977-1642",
            "fax_number": "314-977-1642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 S SPRING AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631102520",
            "telephone_number": "314-977-1642",
            "fax_number": "314-977-1642"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 S Preston St Rm 305",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402021702",
            "country_code": "US",
            "telephone_number": "502-852-8696",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PERKINS",
        "first_name": "JORDAN",
        "middle_name": "TRACE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-05-28",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MO",
            "license": "2021021646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deborah Kay Perkins, FNP-BC
• Grace Perkins, DO
• Irma Jean Perkins, ARPN, MSN
• Izabella Leigh Perkins
• James Perkins
• Kimberlan Minnet Perkins
• Rachelle Ann Perkins
• Stephanie Mabry Perkins, MD
• Suzette Le Van Perkins
• Tierra Perkins

• Surgery Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Surgery Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2021; 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.