Gwendolyn M Perry-Brye, RNC, MS, WHNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

486-033 Issued in WI

Practice address

8600 Sheridan Rd Ste 600
Kenosha, WI 53143-6515

Phone

(262) 605-6700

Fax

(262) 605-6715

NPI assigned

Oct 4, 2005

Last updated

Nov 6, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Cleanslate Medical Group of Wisconsin, SC

  • Addiction Medicine (Internal Medicine) Physician
  • Glendale, WI
  • NPI 1518404854
  Medicare reassignment NPD
• Kenosha County Div of Public Health

  • Clinical Medical Laboratory
  • Kenosha, WI
  • NPI 1477744472
  NPD (past)
• Kenosha County Division of Health

  • Public Health or Welfare Agency
  • Kenosha, WI
  • NPI 1467643130
  NPD (past)

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572998400000",
    "number": "1568459568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3109 SOUTHWOOD DR",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534065415",
            "telephone_number": "262-554-8094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8600 SHERIDAN RD STE 600",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531436515",
            "telephone_number": "262-605-6700",
            "fax_number": "262-605-6715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY-BRYE",
        "first_name": "GWENDOLYN",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "RNC, MS, WHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-04",
        "last_updated": "2019-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "WI",
            "license": "486-033",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "486-033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4385700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christina Ada Perri, L.AC
• Doreen Perri
• Jennifer Marie Perri, L.P.N.
• Michael Perri, RN
• Timothy H Perri, DDS
• Jessica Perry
• Ali Syed Pervez, DO
• Jawad Pervez
• Susanne Peschl, APNP
• Melissa Pestka

• Nurse Practitioner in Kenosha, WI
• Providers in Kenosha, WI by specialty
• Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.