Pervis Enterprise LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

PERVIS ENTERPRISE LLC

Practice address

1 Bradley Rd Ste 505
Woodbridge, CT 06525-2292

Phone

(203) 693-1164

Fax

(203) 446-5599

NPI assigned

Dec 20, 2017

Organization subpart

No

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

Authorized official

Name

Brian D Pervis, APRNNPI 1174939839

Title

President

Phone

(203) 693-1164

Specialties & licenses 2

Addresses

Other names 1

• Integrative Pain and Psych Care Doing business as

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Brian Pervis, APRN

  • Family Nurse Practitioner
  • Woodbridge, CT
  • NPI 1174939839
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1513728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644624000000",
    "number": "1609382134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 S JONES BLVD # 1060",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891072623",
            "telephone_number": "203-693-1164",
            "fax_number": "888-475-7210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BRADLEY RD STE 505",
            "city": "WOODBRIDGE",
            "state": "CT",
            "postal_code": "065252292",
            "telephone_number": "203-693-1164",
            "fax_number": "203-446-5599"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "228 Meadow St # 402",
            "address_purpose": "LOCATION",
            "city": "Waterbury",
            "state": "CT",
            "postal_code": "067021807",
            "country_code": "US",
            "telephone_number": "203-693-1164",
            "fax_number": "203-446-5599",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PERVIS ENTERPRISE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-20",
        "last_updated": "2022-02-12",
        "certification_date": "2022-02-12",
        "status": "A",
        "authorized_official_last_name": "PERVIS",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "203-693-1164",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Integrative Pain and Psych Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kimberly Ann Pearce, ATC,LAT
• Patrycja Marta Pedzinska, MSOTR/L
• Linda Perelberg, LCSW
• Dinesh R Perera, LMFT
• Personal Care Training LLC
• Brian Pervis, APRN
• Aimee Petremont, BCBA
• Beverley Charmaine Phillips-Lewis, LCSW
• Larissa Ann Phillips, OTR/L
• Taylor Piacentini

• Family Nurse Practitioner in Woodbridge, CT
• Providers in Woodbridge, CT by specialty
• Family Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2022; 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.