Individual provider Active NPI

Carolyn G. Perry, MS

  • Speech-Language Pathologist
  • Lubbock, TX
National Provider Identifier
1356435192
Registry record updated Jan 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
16273 Issued in TX
Practice address
3601 4TH St
Suite 2A300
Lubbock, TX 79430-0002
Phone
(806) 743-5678
Fax
(806) 743-5670
NPI assigned
Oct 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 16273 TX Primary

Addresses

Primary practice location

3601 4TH St
Suite 2A300
Lubbock, TX 79430-0002

Mailing address

3601 4TH St
# 2A300
Lubbock, TX 79430-6073
Phone (806) 743-2898

Other identifiers 3

IdentifierTypeStateIssuer
181350301MedicaidTX
80397AOtherTXHMO BLUE
80401AOtherTXBC/BS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address carolyn.perry@direct.myteamcare.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101027000504 TX Practitioner - Qualified Speech Language Pathologist 5294929949 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Tech University Health Sciences Center LubbockGroup PAC ID 4385549674, 363 clinicians

Practice addresses (Care Compare)

3601 4TH St
2A300
Lubbock, TX 79430-6073
Phone (806) 743-5678

Merit-based Incentive Payment System (MIPS)

Final score
99.52 of 100Reported as apm
Quality
87.98
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Tech University Health Sciences Center Lubbock Current Accepting new patients
Texas Tech University Health Sciences Center Lubbock CurrentSince Jul 8, 2010 Accepting new patients
Texas Tech University Health Sciences Center Lubbock Speech-Language Pathologist CurrentSince Jul 8, 2010 Accepting new patients
Texas Tech University Health Sciences Center Lubbock Past Accepting new patients

Locations

3601 4th St
#2A300
Lubbock, TX 79430
Phone (806) 743-5678

3601 4th St
Ste 2A300
Lubbock, TX 79430
Phone (806) 743-5678

3601 4th St
Stop 6073
Lubbock, TX 79430
Phone (806) 743-5612

Interoperability endpoints

  • Direct secure messaging: carolyn.perry@direct.myteamcare.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642636800000",
    "number": "1356435192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 4TH ST",
            "address_2": "# 2A300",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794306073",
            "telephone_number": "806-743-2898",
            "fax_number": "806-743-2787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 4TH ST",
            "address_2": "SUITE 2A300",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794300002",
            "telephone_number": "806-743-5678",
            "fax_number": "806-743-5670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "CAROLYN",
        "middle_name": "G.",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2022-01-20",
        "certification_date": "2022-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "16273",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "181350301",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMO BLUE",
            "identifier": "80397A",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "80401A",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "carolyn.perry@direct.myteamcare.com",
            "affiliation": "N",
            "address_1": "3601 4th St",
            "address_2": "Suite 2A300",
            "city": "Lubbock",
            "state": "TX",
            "country_code": "US",
            "postal_code": "794300002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.