NPIMap

Individual provider Active NPI

Archie Charles Perry Jr., M.D.

  • Orthopaedic Surgery of the Spine Physician
  • Las Vegas, NV
National Provider Identifier
1245218510
Registry record updated Oct 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
License
42033 Issued in NV
Practice address
2800 E Desert Inn Rd Ste 100
Las Vegas, NV 89121-3609
Phone
(702) 731-1616
Fax
(702) 734-4900
NPI assigned
Jan 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery of the Spine Physician 207XS0117X 42033 NV Primary

Addresses

Primary practice location

2800 E Desert Inn Rd Ste 100
Las Vegas, NV 89121-3609

Mailing address

2800 E Desert Inn Rd Ste 100
Las Vegas, NV 89121-3609
Phone (702) 731-1616

Other practice location 1

8205 W Warm Springs Rd Ste 250
Las Vegas, NV 89113-3646
Phone (702) 227-2152

Other practice location 2

8402 Centennial Pkwy
Las Vegas, NV 89149-4792
Phone (702) 869-3486

Other identifiers 4

IdentifierTypeStateIssuer
CC6778OtherBXBS
7499443OtherAETNA
1245218510MedicaidNV
P00142405OtherR.R. MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040629000766 NV Practitioner - Orthopedic Surgery 6507762390 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Nevada School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Desert Orthopaedic Center LTDGroup PAC ID 6406759661, 103 clinicians

Practice addresses (Care Compare)

2800 E Desert Inn Rd
Suite 100
Las Vegas, NV 89121-3609
Phone (702) 731-1616

Hospital & facility affiliations

  • Enhabit Home Health Home health agency, Las Vegas, NV, CCN 297115
  • Southern Hills Hospital and Medical Center Hospital, Las Vegas, NV, CCN 290047
  • Mountainview Hospital Hospital, Las Vegas, NV, CCN 290039
  • University Medical Center Hospital, Las Vegas, NV, CCN 290007
  • Sunrise Hospital and Medical Center Hospital, Las Vegas, NV, CCN 290003
  • Spring Valley Hospital Medical Center Hospital, Las Vegas, NV, CCN 290046

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion170
Laminectomy or laminotomy (partial removal of spine bones)23

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
10910NVMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
42033NVMDOrthopaedic Surgery of the Spine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Desert Orthopaedic Center, LTD. Orthopaedic Surgery CurrentSince Aug 1, 2004 Accepting new patients
Desert Orthopaedic Billing LLC Orthopaedic Surgery Past Accepting new patients
Sunrise Hospital and Medical Center, LLC Past Accepting new patients
Desert Springs Hospital Past Accepting new patients
Spring Valley Medical Center Past Accepting new patients
Mountain View Hospital LLC Past Accepting new patients
Sunrise Mountainview Hospital, Inc. Past Accepting new patients
Southern Hills Medical Center, LLC Past Accepting new patients
Abbott Northwestern Hospital Past Accepting new patients

Locations

2930 W Horizon Ridge Pkwy
Ste 100
Henderson, NV 89052
Phone (702) 263-9082

8402 Centennial Pkwy
Las Vegas, NV 89149
Phone (702) 869-3486

8689 W Charleston Blvd
Ste 105
Las Vegas, NV 89117
Phone (702) 304-5900

8205 W Warm Springs Rd
Ste 250
Las Vegas, NV 89113
Phone (702) 227-2152

2800 E Desert Inn Rd
Ste 100
Las Vegas, NV 89121
Phone (702) 294-7499

Interoperability endpoints

  • Direct secure messaging: aperry12881@direct.umcsn.com
  • Direct secure messaging: perac@doclv.emadirect.md

Organizations & group practices 9

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.

Hospital & facility affiliations 19

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1136419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539216000000",
    "number": "1245218510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 E DESERT INN RD STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891213609",
            "telephone_number": "702-731-1616",
            "fax_number": "702-734-4900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 E DESERT INN RD STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891213609",
            "telephone_number": "702-731-1616",
            "fax_number": "702-734-4900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8205 W Warm Springs Rd Ste 250",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891133646",
            "country_code": "US",
            "telephone_number": "702-227-2152",
            "fax_number": "702-252-0369",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8402 Centennial Pkwy",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891494792",
            "country_code": "US",
            "telephone_number": "702-869-3486",
            "fax_number": "702-869-3542",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PERRY",
        "first_name": "ARCHIE",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-05",
        "last_updated": "2018-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "NV",
            "license": "42033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BXBS",
            "identifier": "CC6778",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7499443",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1245218510",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "R.R. MEDICARE",
            "identifier": "P00142405",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.