NPIMap

Individual provider Active NPI

Anthony Victor Perry Jr., D.O.

  • Internal Medicine Physician
  • Massillon, OH
National Provider Identifier
1619976313
Registry record updated Mar 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
34005325 Issued in OH
Practice address
2458 Lincoln Way E
Massillon, OH 44646-5085
Phone
(330) 837-1111
Fax
(330) 832-1341
NPI assigned
Jul 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 34005325 OH Primary

Addresses

Primary practice location

2458 Lincoln Way E
Massillon, OH 44646-5085

Mailing address

2458 Lincoln Way E
Massillon, OH 44646-5085
Phone (330) 837-1111

Other identifiers 1

IdentifierTypeStateIssuer
0986947MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address drperry@starkmedical.medentdirect.com Direct STARK MEDICAL SPECIALTIES, INC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041116000441 OH Practitioner - Internal Medicine 2961466362 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Ohio University, College of Osteopathic Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stark Medical Specialties, IncGroup PAC ID 5193702819, 3 clinicians

Practice addresses (Care Compare)

2458 Lincoln Way E
Massillon, OH 44646-5085
Phone 3308371111148

Hospital & facility affiliations

  • Aultman Health Care in Your Home Home health agency, Canton, OH, CCN 367290
  • Crossroads Hospice of Northeast Ohio, LLC Hospice, Uniontown, OH, CCN 361625
  • Mercy Medical Center Home Health & Hospice LLC Hospice, Canton, OH, CCN 361534
  • Mercy Medical Center Hospital, Canton, OH, CCN 360070
  • Aultman Hospital Hospital, Canton, OH, CCN 360084
  • Brewster Convalescent Center Nursing home, Brewster, OH, CCN 366264

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
34005325OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stark Medical Specialties, Inc Internal Medicine CurrentSince Dec 1, 1999 Accepting new patients
Cleveland Clinic Mercy Hospital Past Accepting new patients
Aultman Hospital Past Accepting new patients
Brewster Parke, Inc. Past Accepting new patients

Locations

2138 Lincoln Way NW
Massillon, OH 44647
Phone (330) 832-7777

2458 Lincoln Way E
Massillon, OH 44646
Phone (330) 837-1111

323 Marion Ave NW
Ste 200
Massillon, OH 44646
Phone (330) 837-1111

Interoperability endpoints

  • Direct secure messaging: drperry@starkmedical.medentdirect.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Brewster Parke, Inc.Brewster, OH, CCN 366264 Skilled nursing facility Adp of the SNF Dec 18, 2024
Amherst Meadows Skilled Nursing and RehabMassillon, OH, CCN 366284 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Oct 31, 2003
Oct 31, 2003

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1121385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741910400000",
    "number": "1619976313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2458 LINCOLN WAY E",
            "city": "MASSILLON",
            "state": "OH",
            "postal_code": "446465085",
            "telephone_number": "330-837-1111",
            "fax_number": "330-832-1341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2458 LINCOLN WAY E",
            "city": "MASSILLON",
            "state": "OH",
            "postal_code": "446465085",
            "telephone_number": "330-837-1111",
            "fax_number": "330-832-1341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "ANTHONY",
        "middle_name": "VICTOR",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-15",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "34005325",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0986947",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "drperry@starkmedical.medentdirect.com",
            "affiliation": "Y",
            "affiliationName": "STARK MEDICAL SPECIALTIES, INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2458 Lincoln Way E",
            "city": "Massillon",
            "state": "OH",
            "country_code": "US",
            "postal_code": "446465085",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Massillon, OH

Sources for this page

Verify at the official NPI Registry.