Gracen Perkins, PNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

RN259014 Issued in GA

Practice address

3925 Johns Creek CT Ste D
Suwanee, GA 30024-6618

Phone

(770) 622-7742

NPI assigned

Oct 2, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Mountainside Pediatrics

  • Primary Care Clinic/Center
  • Jasper, GA
  • NPI 1710267505
  NPD (past)

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

{
    "created_epoch": "1601596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653264000000",
    "number": "1487251583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 MORNING DOVE LN",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300246077",
            "telephone_number": "404-791-2708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3925 JOHNS CREEK CT STE D",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300246618",
            "telephone_number": "770-622-7742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERKINS",
        "first_name": "GRACEN",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-02",
        "last_updated": "2022-05-23",
        "certification_date": "2022-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "GA",
            "license": "RN259014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "eClinicalWorks",
            "affiliation": "N",
            "endpointDescription": "eMAR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3925 Johns Creek Ct Ste D",
            "city": "Suwanee",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300246618",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mark James Pendergast, DC
• Martha Pennell
• Analia Juliana Peralta Leon
• Perimeter Healthcare Group LLC (Optimum Health Dunwoody)
• Perimeter North Family Medicine
• Steven Lewis Perlow, M.D.
• Perry MD Medical LLC
• Ronald E Perry, M.D.
• Tara F Perry, DMD
• Vanessa Peter

• Pediatric Nurse Practitioner in Suwanee, GA
• Providers in Suwanee, GA by specialty
• Pediatric Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2022; 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.