Individual provider Active NPI

Lacharity Perry, RN

  • Family Nurse Practitioner
  • Greenwood, MS
National Provider Identifier
1205424561
Registry record updated Sep 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
907782 Issued in MS
Practice address
212 W Park Ave
Greenwood, MS 38930-3009
Phone
(662) 453-8508
NPI assigned
Jan 4, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 907782 MS Primary

Addresses

Primary practice location

212 W Park Ave
Greenwood, MS 38930-3009

Mailing address

700 Sunset Dr
Grenada, MS 38901-4091
Phone (662) 307-2884

Other practice location 1

700 Sunset Dr
Grenada, MS 38901-4091
Phone (662) 307-2884

Other identifiers 1

IdentifierTypeStateIssuer
2021Other2021

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL CVS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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

Enrollment IDStateProvider typePAC IDDetails
I20251005000030 MS Practitioner - Nurse Practitioner 7214433572 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fast Pace Mississippi PLLCGroup PAC ID 3678832029, 192 clinicians

Practice addresses (Care Compare)

700 Sunset Dr
Grenada, MS 38901-4091
Phone (662) 307-2884

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
907782MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fast Pace Mississippi, PLLC CurrentSince Sep 10, 2025 Accepting new patients
Fast Pace Mississippi, PLLC Family CurrentSince Sep 10, 2025 Accepting new patients
Upperline Healthcare, PC CurrentSince Sep 25, 2025 Accepting new patients
Upperline Healthcare, PC CurrentSince Sep 25, 2025 Accepting new patients

Locations

700 Sunset Dr
Grenada, MS 38901
Phone (662) 307-2884

7 Professional Pkwy
Ste 101
Hattiesburg, MS 39402
Phone (601) 781-1661

517 City Ave S
Ripley, MS 38663
Phone (662) 587-8206

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1609718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758240000000",
    "number": "1205424561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 SUNSET DR",
            "city": "GRENADA",
            "state": "MS",
            "postal_code": "389014091",
            "telephone_number": "662-307-2884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 W PARK AVE",
            "city": "GREENWOOD",
            "state": "MS",
            "postal_code": "389303009",
            "telephone_number": "662-453-8508"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 Sunset Dr",
            "address_purpose": "LOCATION",
            "city": "Grenada",
            "state": "MS",
            "postal_code": "389014091",
            "country_code": "US",
            "telephone_number": "662-307-2884",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PERRY",
        "first_name": "LACHARITY",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-04",
        "last_updated": "2025-09-19",
        "certification_date": "2025-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "907782",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "2021",
            "identifier": "2021",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "CVS",
            "affiliation": "N",
            "address_1": "212 W Park Ave",
            "city": "Greenwood",
            "state": "MS",
            "country_code": "US",
            "postal_code": "389303009",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greenwood, MS

Sources for this page

Verify at the official NPI Registry.