Individual provider Active NPI

Ciara Latrice Perry, ATC

  • Athletic Trainer
  • Chicago, IL
National Provider Identifier
1497878615
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
Practice address
12149 S Eggleston Ave
Chicago, IL 60628-6305
Phone
(773) 995-6958
NPI assigned
Apr 10, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X Primary

Addresses

Primary practice location

12149 S Eggleston Ave
Chicago, IL 60628-6305

Mailing address

12149 S Eggleston Ave
Chicago, IL 60628-6305
Phone (773) 995-6958

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

NPI Registry JSON

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497878615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12149 S EGGLESTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606286305",
            "telephone_number": "773-995-6958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12149 S EGGLESTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606286305",
            "telephone_number": "773-995-6958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "CIARA",
        "middle_name": "LATRICE",
        "name_prefix": "Ms.",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.