Individual provider Active NPI

Jamie Diane Perro, AUDIOLOGIST

  • Audiologist
  • Fairfield, CA
National Provider Identifier
1376874529
Registry record updated Nov 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AU2789 Issued in CA
Practice address
1287 Oliver Rd
Fairfield, CA 94534-3468
Phone
(707) 426-4327
Fax
(707) 426-5190
NPI assigned
Jan 27, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 147.001330 IL
Audiologist 231H00000X AU2789 CA Primary

Addresses

Primary practice location

1287 Oliver Rd
Fairfield, CA 94534-3468

Mailing address

1287 Oliver Rd
Fairfield, CA 94534-3468
Phone (707) 426-4327

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
AU2789CAMDAudiologist
147.001330ILMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Ear Nose & Throat Associates S.C. PastSince Jan 1, 2011 Accepting new patients
Pine River, Inc. Past Accepting new patients

Organizations & group practices 2

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": "1264550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353888000000",
    "number": "1376874529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1287 OLIVER RD",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945343468",
            "telephone_number": "707-426-4327",
            "fax_number": "707-426-5190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1287 OLIVER RD",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945343468",
            "telephone_number": "707-426-4327",
            "fax_number": "707-426-5190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRO",
        "first_name": "JAMIE",
        "middle_name": "DIANE",
        "name_prefix": "Mrs.",
        "credential": "AUDIOLOGIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-27",
        "last_updated": "2012-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "IL",
            "license": "147.001330",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "CA",
            "license": "AU2789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2012; 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.