Individual provider Active NPI

Michelle B Perry, APRN

  • Family Nurse Practitioner
  • Coffeyville, KS
National Provider Identifier
1487021580
Registry record updated Aug 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
76900 Issued in KS
Practice address
1400 W 4TH St
Coffeyville, KS 67337-3306
Phone
(620) 251-1200
NPI assigned
Aug 25, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 76900 KS Primary

Addresses

Primary practice location

1400 W 4TH St
Coffeyville, KS 67337-3306

Mailing address

PO Box 505262
Saint Louis, MO 63150-5262
Phone (620) 251-1200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20190205000580 OK Practitioner - Nurse Practitioner 9739496910 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeastern Health SystemGroup PAC ID 1456255025, 105 clinicians

Practice addresses (Care Compare)

1400 E Downing St
Tahlequah, OK 74464-3324
Phone (918) 456-0641

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.91 of 100Reported as apm
Quality
76.55
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
76900KSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tahlequah Medical Group LLC CurrentSince Sep 17, 2021 Accepting new patients
Northeastern Health System CurrentSince Sep 17, 2021 Accepting new patients
Northeastern Health System CurrentSince Sep 17, 2021 Accepting new patients
Northeastern Health System Current Accepting new patients
Jack E Weaver, MD PC CurrentSince Feb 1, 2019 Accepting new patients
Northeastern Health System Past Accepting new patients

Locations

209 S 36th St
Muskogee, OK 74401
Phone (918) 682-7717

1400 E Downing St
Tahlequah, OK 74464
Phone (918) 456-0641

205 Harris Cir
Ste 202
Tahlequah, OK 74464
Phone (918) 207-1410

Interoperability endpoints

  • Direct secure messaging: michelle.perry@1345.chartlogic.direct-ci.com
  • FHIR API: https://fhir-myrecord.cerner.com/r4/932b43fb-c766-413c-a343-640549d20cb3/

Organizations & group practices 6

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 6

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": "1440460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440979200000",
    "number": "1487021580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 505262",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631505262",
            "telephone_number": "620-251-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 W 4TH ST",
            "city": "COFFEYVILLE",
            "state": "KS",
            "postal_code": "673373306",
            "telephone_number": "620-251-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "MICHELLE",
        "middle_name": "B",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-25",
        "last_updated": "2015-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "76900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coffeyville, KS

Sources for this page

Verify at the official NPI Registry.