Active NPI
Jimmy Ray Perkins Jr.
- Case Manager/Care Coordinator
- Muskogee, OK
National Provider Identifier
1194094037
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- License
- 23714
- Practice address
- 3300 Chandler Rd Ste 109
Muskogee, OK 74403-4909 - Phone
- (918) 686-6876
- Fax
- (918) 686-6826
- NPI assigned
- Dec 21, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | 23714 | OK | Primary |
Addresses
Primary practice location
3300 Chandler Rd Ste 109
Muskogee, OK 74403-4909
Mailing address
2505 Monta PL
Muskogee, OK 74403-6032
Phone (918) 231-7425
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23714 | OK | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Summercrest Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Professional Counselor
- Muskogee, OK
- NPI 1710180310
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1324425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1324425600000",
"number": "1194094037",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2505 MONTA PL",
"city": "MUSKOGEE",
"state": "OK",
"postal_code": "744036032",
"telephone_number": "918-231-7425"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3300 CHANDLER RD STE 109",
"city": "MUSKOGEE",
"state": "OK",
"postal_code": "744034909",
"telephone_number": "918-686-6876",
"fax_number": "918-686-6826"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PERKINS",
"first_name": "JIMMY",
"middle_name": "RAY",
"name_suffix": "Jr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-12-21",
"last_updated": "2011-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "OK",
"license": "23714",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Muskogee, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.