Carrie Pualanileimakamae Pereyra, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

Brigham Young University
173 Richards Building
Provo, UT 84602

Phone

(801) 422-1628

NPI assigned

Mar 22, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1521676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521676800000",
    "number": "1376047464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "291 W 1150 N",
            "city": "SPRINGVILLE",
            "state": "UT",
            "postal_code": "846634212",
            "telephone_number": "808-640-4955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BRIGHAM YOUNG UNIVERSITY",
            "address_2": "173 RICHARDS BUILDING",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "84602",
            "telephone_number": "801-422-1628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREYRA",
        "first_name": "CARRIE",
        "middle_name": "PUALANILEIMAKAMAE",
        "name_prefix": "Mrs.",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-22",
        "last_updated": "2018-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "UT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elisabeth Marie Pendleton
• Pennington Medical Center (Pennington Women's Center)
• Randal S Pennington, PSYD
• Taylor Marie Percival
• Brittany Tucker Perdue, A.T.C.
• Karen Nazareth Perez Rodriguez
• Adam Perez
• Rosario Elena Perez I, SSW, CSW
• Sotero Leon Perigo
• Lucy Perkins

• Athletic Trainer in Provo, UT
• Providers in Provo, UT by specialty
• Athletic Trainer in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2018; 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.