Individual provider Active NPI

Thomas Matthew Perry Jr., PHARMD

  • Pharmacist
  • Hardeeville, SC
National Provider Identifier
1396568069
Registry record updated Nov 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH.60417 Issued in SC
Practice address
112 Nickle Plate Rd
Hardeeville, SC 29927-4414
Phone
(843) 208-3605
Fax
(843) 288-4656
NPI assigned
Nov 1, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH.60417 SC Primary

Addresses

Primary practice location

112 Nickle Plate Rd
Hardeeville, SC 29927-4414

Mailing address

112 Nickle Plate Rd
Hardeeville, SC 29927-4414
Phone (843) 208-3605

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PH.60417SCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Publix Super Markets Inc CurrentSince Nov 3, 2024 Accepting new patients
Publix Super Markets Inc PastSince Nov 3, 2024 Accepting new patients

Locations

112 Nickle Plate Rd
Hardeeville, SC 29927
Phone (843) 208-3605

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": "1730419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730419200000",
    "number": "1396568069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 NICKLE PLATE RD",
            "city": "HARDEEVILLE",
            "state": "SC",
            "postal_code": "299274414",
            "telephone_number": "843-208-3605",
            "fax_number": "843-288-4656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 NICKLE PLATE RD",
            "city": "HARDEEVILLE",
            "state": "SC",
            "postal_code": "299274414",
            "telephone_number": "843-208-3605",
            "fax_number": "843-288-4656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "THOMAS",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-11-01",
        "last_updated": "2024-11-01",
        "certification_date": "2024-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "SC",
            "license": "PH.60417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hardeeville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2024; 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.