Individual provider Active NPI

Kenya Perry

  • Specialist
  • Forest Hills, NY
National Provider Identifier
1306184262
Registry record updated Jan 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
666135 Issued in NY
Practice address
7000 Austin St Ste 200
Forest Hills, NY 11375-1022
Phone
(718) 762-7633
Fax
(212) 679-5894
NPI assigned
Jan 27, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 666135 NY Primary

Addresses

Primary practice location

7000 Austin St Ste 200
Forest Hills, NY 11375-1022

Mailing address

14619 107TH Ave
Jamaica, NY 11435-5235
Phone (718) 291-6652

Other identifiers 1

IdentifierTypeStateIssuer
1215KENMedicaidNY

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
666135NYMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1359244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359244800000",
    "number": "1306184262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14619 107TH AVE",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114355235",
            "telephone_number": "718-291-6652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7000 AUSTIN ST STE 200",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113751022",
            "telephone_number": "718-762-7633",
            "fax_number": "212-679-5894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "KENYA",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-27",
        "last_updated": "2013-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "666135",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1215KEN",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2013; 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.