Individual provider Active NPI

Lindsey J. Perry IV, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Salt Lake City, UT
National Provider Identifier
1306309471
Registry record updated Sep 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
11940158-1205 Issued in UT
Practice address
15 N Medical Dr Ste 1100
Salt Lake City, UT 84112-1100
Phone
(801) 581-4390
NPI assigned
Apr 7, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 11940158-1205 UT Primary

Addresses

Primary practice location

15 N Medical Dr Ste 1100
Salt Lake City, UT 84112-1100

Mailing address

15 N Medical Dr Ste 1100
Salt Lake City, UT 84112-1100
Phone (801) 581-4390

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, NC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20250613001446 VA Practitioner - Pathology 8820509276 Reassigns benefits to 1 organization
I20250818003650 NC Practitioner - Pathology 8820509276 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Texas Medical Branch at Galveston, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pathology Sciences Medical Group PC 26 clinicians

Practice addresses (Care Compare)

1144 N Rd St
Elizabeth City, NC 27909-3473
Phone (252) 384-4763

600 Gresham Dr
Norfolk, VA 23507-1904
Phone (757) 668-3221

Hospital & facility affiliations

  • Sentara Norfolk General Hospital Hospital, Norfolk, VA, CCN 490007
  • Sentara Leigh Hospital Hospital, Norfolk, VA, CCN 490046
  • Sentara Princess Anne Hospital Hospital, Virginia Beach, VA, CCN 490119
  • Sentara Obici Hospital Hospital, Suffolk, VA, CCN 490044
  • Sentara Careplex Hospital Hospital, Hampton, VA, CCN 490093

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11940158-1205UTMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pathology Sciences Medical Group, PC Anatomic Pathology & Clinical Pathology CurrentSince Jul 28, 2025 Accepting new patients

Locations

1144 N Road St
Elizabeth Cty, NC 27909
Phone (252) 384-4610

600 Gresham Dr
Norfolk, VA 23507
Phone (757) 473-0055

1060 First Colonial Rd
Virginia Beach, VA 23454
Phone (757) 395-2323

Organizations & group practices 1

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

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": "1554595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600128000000",
    "number": "1306309471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 N MEDICAL DR STE 1100",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841121100",
            "telephone_number": "801-581-4390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 N MEDICAL DR STE 1100",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841121100",
            "telephone_number": "801-581-4390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "LINDSEY",
        "middle_name": "J.",
        "name_suffix": "IV",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-07",
        "last_updated": "2020-09-15",
        "certification_date": "2020-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "UT",
            "license": "11940158-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.