Individual provider Active NPI

Jackson Seipp Perry, MD, MBA

  • Student in an Organized Health Care Education/Training Program
  • Chapel Hill, NC
National Provider Identifier
1578201612
Registry record updated May 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
RTL22-0415 Issued in NC
Practice address
101 Manning Dr
Chapel Hill, NC 27514-4226
Phone
(984) 974-1000
NPI assigned
May 26, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X RTL22-0415 NC Primary

Addresses

Primary practice location

101 Manning Dr
Chapel Hill, NC 27514-4226

Mailing address

1400 Mason Farm Rd Unit a
Chapel Hill, NC 27514-4606
Phone (252) 560-6833

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220621002601 NC Order and Referring Only - Orthopedic SurgeryPractitioner - Orthopedic Surgery 5597144634

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Business Administration, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
RTL22-0415NCMDStudent in an Organized Health Care Education/Training Program

Interoperability endpoints

  • Direct secure messaging: jperry324607@direct.unc.nchie.net
  • Direct secure messaging: jperry247147@directhisp.wakemed.org

NPI Registry JSON

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

{
    "created_epoch": "1653523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653523200000",
    "number": "1578201612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 MASON FARM RD UNIT A",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275144606",
            "telephone_number": "252-560-6833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MANNING DR",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275144226",
            "telephone_number": "984-974-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "JACKSON",
        "middle_name": "SEIPP",
        "name_prefix": "Dr.",
        "credential": "MD, MBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-26",
        "last_updated": "2022-05-26",
        "certification_date": "2022-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NC",
            "license": "RTL22-0415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chapel Hill, NC

Sources for this page

Verify at the official NPI Registry.