Individual provider Active NPI

Jamie Perry, FNP-C

  • Nurse Practitioner
  • Bangor, ME
National Provider Identifier
1447780002
Registry record updated Jan 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
CNP171065 Issued in ME
Practice address
900 Broadway BLDG 1
Bangor, ME 04401-1900
Phone
(207) 907-3010
Fax
(207) 907-3011
NPI assigned
Jun 15, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X CNP171065 ME Primary

Addresses

Primary practice location

900 Broadway BLDG 1
Bangor, ME 04401-1900

Mailing address

900 Broadway BLDG 1
Bangor, ME 04401-1900
Phone (207) 290-7301

Other practice location 1

175 W Broadway
Lincoln, ME 04457-4000
Phone (207) 794-6700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171005003250 ME Practitioner - Nurse Practitioner 8820363542 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Joseph HospitalGroup PAC ID 6406766336, 197 clinicians

Practice addresses (Care Compare)

360 Broadway
L
Bangor, ME 04401-3979
Phone (207) 907-1000

Hospital & facility affiliations

  • St Joseph Hospital Hospital, Bangor, ME, CCN 200001

Merit-based Incentive Payment System (MIPS)

Final score
96.58 of 100Reported as apm
Quality
83.17
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
CNP171065MEMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Joseph Hospital CurrentSince Oct 15, 2021 Accepting new patients

Locations

360 Broadway
#L
Bangor, ME 04401
Phone (207) 262-1703

360 Broadway
Bangor, ME 04401
Phone (207) 262-1703

900 Broadway
Bldg 1
Bangor, ME 04401
Phone (207) 907-1187

Interoperability endpoints

  • Direct secure messaging: jperry1154630@direct.bsmhealth.org

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 1

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": "1497484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610323200000",
    "number": "1447780002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 BROADWAY BLDG 1",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044011900",
            "telephone_number": "207-290-7301",
            "fax_number": "207-907-3011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 BROADWAY BLDG 1",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044011900",
            "telephone_number": "207-907-3010",
            "fax_number": "207-907-3011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "175 W Broadway",
            "address_purpose": "LOCATION",
            "city": "Lincoln",
            "state": "ME",
            "postal_code": "044574000",
            "country_code": "US",
            "telephone_number": "207-794-6700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PERRY",
        "first_name": "JAMIE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-15",
        "last_updated": "2021-01-11",
        "certification_date": "2021-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ME",
            "license": "CNP171065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bangor, ME

Sources for this page

Verify at the official NPI Registry.