Organization Active NPI

Perry MD Medical LLC

  • Primary Care Clinic/Center
  • Suwanee, GA
National Provider Identifier
1558177410
Registry record updated Jul 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
PERRY MD MEDICAL LLC
Practice address
1300 Peachtree Industrial Blvd Ste 4103
Suwanee, GA 30024-4543
Phone
(678) 677-5973
Fax
(770) 831-5527
NPI assigned
Dec 5, 2024
Last updated
Jul 25, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2025

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

Authorized official

Name
Dr. Ronald E Perry, MDNPI 1932123015
Title
Ceo
Phone
(770) 831-5525

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X NU Primary

Addresses

Primary practice location

1300 Peachtree Industrial Blvd Ste 4103
Suwanee, GA 30024-4543

Mailing address

1300 Peachtree Industrial Blvd Ste 4103
Suwanee, GA 30024-4543
Phone (678) 677-5973

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250807001790 GA Part B Supplier - Clinic/Group Practice 4082112271 Receives reassigned benefits from 2 practitioners
Practice locations: Gainesville, GA; Suwanee, GA

National Provider Directory

National Provider Directory

Locations

1429 Thompson Bridge Rd
Ste 200
Gainesville, GA 30501
Phone (770) 831-5525

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1733356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753401600000",
    "number": "1558177410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 PEACHTREE INDUSTRIAL BLVD STE 4103",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300244543",
            "telephone_number": "678-677-5973",
            "fax_number": "770-831-5527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 PEACHTREE INDUSTRIAL BLVD STE 4103",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300244543",
            "telephone_number": "678-677-5973",
            "fax_number": "770-831-5527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERRY MD MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-05",
        "last_updated": "2025-07-25",
        "certification_date": "2025-07-25",
        "status": "A",
        "authorized_official_last_name": "PERRY",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "770-831-5525",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suwanee, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.