Perigon Prostate Center LLC

Primary specialty

Mobile Radiology Clinic/CenterTaxonomy code 261QR0208X

Legal business name

PERIGON PROSTATE CENTER LLC

Practice address

100 SE 59TH St
Oklahoma City, OK 73129-3616

Phone

(408) 418-2200

Fax

(405) 418-2901

NPI assigned

Oct 26, 2022

Organization subpart

No

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

Authorized official

Name

Derek Prentice

Title

Owner

Phone

(405) 650-4786

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1666742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666742400000",
    "number": "1184341489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5600 N MAY AVE STE 100",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731124275",
            "telephone_number": "405-418-2200",
            "fax_number": "405-418-2901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SE 59TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731293616",
            "telephone_number": "408-418-2200",
            "fax_number": "405-418-2901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERIGON PROSTATE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-26",
        "last_updated": "2022-10-26",
        "certification_date": "2022-10-26",
        "status": "A",
        "authorized_official_last_name": "PRENTICE",
        "authorized_official_first_name": "DEREK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-650-4786"
    },
    "taxonomies": [
        {
            "code": "261QR0208X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mobile",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Marie Perham, OTA/L
• Jaime Peri
• Perigon Alzheimers LLC
• Perigon Early Alzheimer'S & Brain Treatment Center
• Perigon Imaging LLC
• Kristin Lynn Perkey, APRN-CNP
• Abigail Perkins
• Barry Grant Perkins, M.D.
• Brynn Perkins, PA-C
• Carl Perkins

• Mobile Radiology Clinic/Center in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Mobile Radiology Clinic/Center in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2022; 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.