NPIMap

Individual provider Active NPI

Anisaa Widyawati Romano Perry, D.O.

  • Family Medicine Physician
  • Andrews, NC
National Provider Identifier
1285073536
Registry record updated Jun 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2021-02955 Issued in NC
Practice address
2751 US-19 Bus
Andrews, NC 28901
Phone
(828) 321-4510
NPI assigned
Jun 20, 2013
Last updated
Jun 30, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Family Medicine Physician 207Q00000X 2021-02955 NC Primary

Addresses

Primary practice location

2751 US-19 Bus
Andrews, NC 28901

Mailing address

1021 Darrington Dr Ste 101
Cary, NC 27513-8158
Phone (919) 852-3999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20211209002980 NC Practitioner - Family PracticePractitioner - Osteopathic Manipulative Medicine 9537408042 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Osteopathic Manipulative Medicine
Education
Touro Un Col of Osteopathic Medicine, New York, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Murphy Medical Center IncGroup PAC ID 7416856547, 70 clinicians

Practice addresses (Care Compare)

2751 US-19 Business
Andrews, NC 28901
Phone (828) 321-4510

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2021-02955NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Generations Family Practice, PA CurrentSince Dec 1, 2021 Accepting new patients
Generations Family Practice, PA Family Medicine CurrentSince Dec 1, 2021 Accepting new patients
Murphy Medical Center Inc Current Accepting new patients
Murphy Medical Center, Inc. Family Medicine CurrentSince Dec 17, 2023 Accepting new patients
Murphy Medical Center, Inc. CurrentSince Dec 17, 2023 Accepting new patients
Murphy Medical Center, Inc. Past Accepting new patients

Locations

2751 Business 19
Andrews, NC 28901
Phone (828) 321-4510

1021 Darrington Dr
Ste 101
Cary, NC 27513
Phone (919) 852-3339

1309 Lees Chapel Rd
Greensboro, NC 27455
Phone (336) 286-5505

145 Medical Park Ln
Ste L
Murphy, NC 28906
Phone (828) 349-3376

75 Medical Park Ln
Ste D
Murphy, NC 28906
Phone (828) 835-4741

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1371686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688083200000",
    "number": "1285073536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 DARRINGTON DR STE 101",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275138158",
            "telephone_number": "919-852-3999",
            "fax_number": "919-378-9114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2751 US-19 BUS",
            "city": "ANDREWS",
            "state": "NC",
            "postal_code": "28901",
            "telephone_number": "828-321-4510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMANO PERRY",
        "first_name": "ANISAA",
        "middle_name": "WIDYAWATI",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-20",
        "last_updated": "2023-06-30",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2021-02955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Andrews, NC

Sources for this page

Verify at the official NPI Registry.