Active NPI
Destiny Lynn Perez, RN
- Registered Nurse
- Maumee, OH
National Provider Identifier
1255955431
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- RN.497098
- Practice address
- 1655 Holland Rd
Maumee, OH 43537-1656 - Phone
- (513) 834-7063
- NPI assigned
- Jun 3, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Registered Nurse | 163WP0808X | RN.497098 | OH | |
| Licensed Practical Nurse | 164W00000X | LPN.173629.MEDS-IV | OH | |
| Registered Nurse | 163W00000X | RN.497098 | OH | Primary |
Addresses
Primary practice location
1655 Holland Rd
Maumee, OH 43537-1656
Mailing address
615 Elsinore PL Ste 200
Cincinnati, OH 45202-1457
Phone (513) 834-7063
Other practice location 1
2005 Ashland Ave
Toledo, OH 43620-1703
Phone (419) 841-7701
Other practice location 2
1757 Indian Wood Cir
Maumee, OH 43537-4009
Phone (833) 641-0632
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN.497098 | OH | MD | Registered Nurse |
| LPN.173629.MEDS-IV | OH | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1591142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1652745600000",
"number": "1255955431",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "615 ELSINORE PL STE 200",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452021457",
"telephone_number": "513-834-7063"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1655 HOLLAND RD",
"city": "MAUMEE",
"state": "OH",
"postal_code": "435371656",
"telephone_number": "513-834-7063"
}
],
"practiceLocations": [
{
"address_1": "2005 Ashland Ave",
"address_purpose": "LOCATION",
"city": "Toledo",
"state": "OH",
"postal_code": "436201703",
"country_code": "US",
"telephone_number": "419-841-7701",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1757 Indian Wood Cir",
"address_purpose": "LOCATION",
"city": "Maumee",
"state": "OH",
"postal_code": "435374009",
"country_code": "US",
"telephone_number": "833-641-0632",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PEREZ",
"first_name": "DESTINY",
"middle_name": "LYNN",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-06-03",
"last_updated": "2022-05-17",
"certification_date": "2022-05-17",
"status": "A"
},
"taxonomies": [
{
"code": "163WP0808X",
"taxonomy_group": "",
"desc": "Registered Nurse, Psychiatric/Mental Health",
"state": "OH",
"license": "RN.497098",
"primary": false
},
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "OH",
"license": "LPN.173629.MEDS-IV",
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "OH",
"license": "RN.497098",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Maumee, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 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.