Jacquelyn S Perry, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD.30790 Issued in AL

Practice address

3601 SW 160TH Ave
Suite 250
Miramar, FL 33027-6308

Phone

(877) 866-7123

NPI assigned

Jun 19, 2008

Last updated

May 14, 2012By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family PracticeAlso: Peripheral Vascular Disease

Education

Meharry Medical College School of Medicine, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Vohra Wound Physicians of FL LLCGroup PAC ID 6406039882, 73 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cavalier Healthcare of Trussville Nursing home, Trussville, AL, CCN 015467

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Vohra Wound Physicians of FL, LLC

  • Family Medicine Physician
  • Miramar, FL
  • NPI 1629374327

  AL

  Medicare reassignment Care Compare group NPD
• Vohra Wound Physicians of FL, LLC

  • Family Medicine Physician
  • Conyers, GA
  • NPI 1598061293
  NPD
• Vohra Wound Physicians of FL, LLC

  • Family Medicine Physician
  • Richmond, VA
  • NPI 1205130911
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Cavalier Healthcare of Trussville, LLC

  • Skilled Nursing Facility
  • Trussville, AL
  • NPI 1366137044

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1213833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336953600000",
    "number": "1457512790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 GABLES DR",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352441848",
            "telephone_number": "205-914-0107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 SW 160TH AVE",
            "address_2": "SUITE 250",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330276308",
            "telephone_number": "877-866-7123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "JACQUELYN",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-19",
        "last_updated": "2012-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "VA",
            "license": "0116018730",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "MD.30790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaith Marlich Pericles, RBT
• Ana Lys Perlacia Real
• Luceydis Pernut
• Danielle Perrodin, PHARMD
• Frances Perry Cave, APRN
• Amanda Rena Persad
• Anand Persad
• Amanda Natasha Persaud-Deosaran, APRN
• Lyndere M Persaud
• Sarah Jane Persaud, OD

• Family Medicine Physician in Miramar, FL
• Providers in Miramar, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.