Individual provider Active NPI

Arianna E Apelgren Perra, PSY.D.

  • Clinical Psychologist
  • Traverse City, MI
National Provider Identifier
1588047757
Registry record updated Mar 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301018320 Issued in MI
Practice address
5191 Rosewood Dr
Traverse City, MI 49685-9137
Phone
(616) 840-7269
NPI assigned
Jul 7, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6301018320 MI Primary

Addresses

Primary practice location

5191 Rosewood Dr
Traverse City, MI 49685-9137

Mailing address

235 Wealthy St SE
Grand Rapids, MI 49503-5247
Phone (616) 840-7135

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address aperra96450@direct.covenanthealthcare.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200520002996 MI Practitioner - Clinical Psychologist 9830480508 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mary Free Bed Rehabilitation HospitalGroup PAC ID 4587576541, 135 clinicians

Practice addresses (Care Compare)

235 Wealthy St SE
Grand Rapids, MI 49503-5247
Phone (616) 242-0422

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
05555MDMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Free Bed Rehabilitation Hospital CurrentSince Apr 12, 2020 Accepting new patients
Mary Free Bed Rehabilitation Hospital CurrentSince Apr 12, 2020 Accepting new patients
Mary Free Bed Rehabilitation Hospital Past Accepting new patients

Locations

235 Wealthy St SE
Grand Rapids, MI 49503
Phone (616) 242-0422

Interoperability endpoints

  • Direct secure messaging: aperra96450@direct.covenanthealthcare.com

Organizations & group practices 3

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": "1436227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711497600000",
    "number": "1588047757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 WEALTHY ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495035247",
            "telephone_number": "616-840-7135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5191 ROSEWOOD DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496859137",
            "telephone_number": "616-840-7269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRA",
        "first_name": "ARIANNA",
        "middle_name": "E APELGREN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-07",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301018320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aperra96450@direct.covenanthealthcare.com",
            "affiliation": "N",
            "address_1": "5191 Rosewood Dr",
            "city": "Traverse City",
            "state": "MI",
            "country_code": "US",
            "postal_code": "496859137",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

Verify at the official NPI Registry.