Individual provider Active NPI

Perry Micheal Adams, PA-C

  • Physician Assistant
  • Salisbury, MD
National Provider Identifier
1538255690
Registry record updated Jan 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C0001363 Issued in MD
Practice address
1415 Wesley Dr
Salisbury, MD 21801-7130
Phone
(410) 912-7000
Fax
(410) 912-4202
NPI assigned
Oct 5, 2006
Last updated
Jan 9, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C0001363 MD Primary

Addresses

Primary practice location

1415 Wesley Dr
Salisbury, MD 21801-7130

Mailing address

1415 Wesley Dr
Salisbury, MD 21801-7130
Phone (410) 912-7000

Other identifiers 1

IdentifierTypeStateIssuer
430401200MedicaidMD

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
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
C0001363MDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Gateway Pediatrics, LLC Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CDAHBA
  • Direct secure messaging: perry.adams@gatewaypeds.eclinicaldirectplus.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389225600000",
    "number": "1538255690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 WESLEY DR",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218017130",
            "telephone_number": "410-912-7000",
            "fax_number": "410-912-4202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 WESLEY DR",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218017130",
            "telephone_number": "410-912-7000",
            "fax_number": "410-912-4202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADAMS",
        "first_name": "PERRY",
        "middle_name": "MICHEAL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2014-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0001363",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "430401200",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salisbury, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2014; 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.