NPIMap

Organization Active NPI

Perry Senior Service

  • Health Maintenance Organization
  • Pooler, GA
National Provider Identifier
1275872053
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
Legal business name
PERRY SENIOR SERVICE
Practice address
3 Redwall Cir
Pooler, GA 31322-9040
Phone
(912) 306-6057
Fax
(912) 349-1937
NPI assigned
Feb 13, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mrs. Katina Shantel Perry
Title
Owner Operator
Phone
(912) 306-6057

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X GA Primary

Addresses

Primary practice location

3 Redwall Cir
Pooler, GA 31322-9040

Mailing address

3 Redwall Cir
Pooler, GA 31322-9040
Phone (912) 306-6057

National Provider Directory

National Provider Directory
Tax ID family
Perry Senior Care2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1360713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1275872053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 REDWALL CIR",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313229040",
            "telephone_number": "912-306-6057",
            "fax_number": "912-349-1937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 REDWALL CIR",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313229040",
            "telephone_number": "912-306-6057",
            "fax_number": "912-349-1937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERRY SENIOR SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-13",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "PERRY",
        "authorized_official_first_name": "KATINA",
        "authorized_official_middle_name": "SHANTEL",
        "authorized_official_title_or_position": "OWNER OPERATOR",
        "authorized_official_telephone_number": "912-306-6057",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pooler, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.

Verify at the official NPI Registry.