Individual provider Active NPI

Ella M Perry, ADDICTION COUNSELOR

  • Addiction (Substance Use Disorder) Counselor
  • Rome, GA
National Provider Identifier
1245652411
Registry record updated Jan 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
1014A0400X Issued in GA
Practice address
6 Mathis Dr NW
Rome, GA 30165-1242
Phone
(706) 291-7201
Fax
(706) 291-7198
NPI assigned
Jan 7, 2014
Last updated
Jan 7, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1014A0400X GA Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 101YA0400X GA

Addresses

Primary practice location

6 Mathis Dr NW
Rome, GA 30165-1242

Mailing address

6 Mathis Dr NW
Rome, GA 30165-1242
Phone (706) 291-7201

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

LicenseStateTypeSpecialty
1014A0400XGAMDCounselor
101YA0400XGAMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1389052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389052800000",
    "number": "1245652411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 MATHIS DR NW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301651242",
            "telephone_number": "706-291-7201",
            "fax_number": "706-291-7198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 MATHIS DR NW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301651242",
            "telephone_number": "706-291-7201",
            "fax_number": "706-291-7198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "ELLA",
        "middle_name": "M",
        "credential": "ADDICTION COUNSELOR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-07",
        "last_updated": "2014-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "GA",
            "license": "1014A0400X",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "GA",
            "license": "101YA0400X",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rome, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2014; 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.