Individual provider Active NPI

Chad A Perry, PA C

  • Medical Physician Assistant
  • Macon, GA
National Provider Identifier
1508980947
Registry record updated May 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
4573 Issued in GA
Practice address
308 Coliseum Dr
Suite 200
Macon, GA 31217-3876
Phone
(478) 742-2180
Fax
(478) 745-2623
NPI assigned
Mar 19, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 4573 GA Primary

Addresses

Primary practice location

308 Coliseum Dr
Suite 200
Macon, GA 31217-3876

Mailing address

308 Coliseum Dr
Suite 200
Macon, GA 31217-3876
Phone (478) 742-2180

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20070622000465 GA Practitioner - Physician Assistant 4082713615 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Skin Care Physicians of Georgia, P.C..Group PAC ID 7517850712, 15 clinicians

Practice addresses (Care Compare)

120 N Lee St
Forsyth, GA 31029-2122
Phone (229) 271-4652

308 Coliseum Dr
Macon, GA 31217-3861
Phone (478) 742-2180

910 N 5TH St
Cordele, GA 31015-3254
Phone (229) 271-4652

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
4573GAMDMedical Physician Assistant

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.

NPI Registry JSON

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211155200000",
    "number": "1508980947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 COLISEUM DR",
            "address_2": "SUITE 200",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312173876",
            "telephone_number": "478-742-2180",
            "fax_number": "478-745-2623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 COLISEUM DR",
            "address_2": "SUITE 200",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312173876",
            "telephone_number": "478-742-2180",
            "fax_number": "478-745-2623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "CHAD",
        "middle_name": "A",
        "credential": "PA C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-19",
        "last_updated": "2008-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "4573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.