Individual provider Active NPI

Dwan Rozzel Perry, D.O.

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Lexington, KY
National Provider Identifier
1639304942
Registry record updated Sep 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X
License
04197 Issued in KY
Practice address
310 S Limestone Street Suite A100A
Lexington, KY 40536-8202
Phone
(859) 257-2573
Fax
(859) 323-0096
NPI assigned
May 16, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2018

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X 0102203436 VA
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X TP990 KY
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X 2736 TN
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X 0102203436 VA
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X 04197 KY Primary

Addresses

Primary practice location

310 S Limestone Street Suite A100A
Lexington, KY 40536-8202

Mailing address

2050 Versailles Rd
Lexington, KY 40504-1405
Phone (859) 257-4888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20170711002277 KY Practitioner - Physical Medicine and Rehabilitation 5193946929 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
West Virginia School of Osteopathic Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kentucky Medical Services Foundation, IncGroup PAC ID 5698689909, 949 clinicians

Practice addresses (Care Compare)

100 Greatstone PT
Lexington, KY 40504-3274
Phone (859) 257-9800

2050 Versailles Rd
Lexington, KY 40504-1405
Phone (859) 254-5701

2400 Greatstone PT
Lexington, KY 40504-3274
Phone (859) 323-7426

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.77 of 100Reported as group
Quality
68.25
Promoting interoperability
100
Improvement activities
40
Cost
72.39

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
04197KYMDSports Medicine (Physical Medicine & Rehabilitation) Physician
0102203436VAMDSports Medicine (Physical Medicine & Rehabilitation) Physician
2736TNMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Kentucky Medical Services Foundation, Inc CurrentSince Jul 1, 2017 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
University of Kentucky Past Accepting new patients

Locations

2400 Greatstone Pt
Lexington, KY 40504
Phone (859) 257-9800

310 S Limestone
Ste A100A
Lexington, KY 40508
Phone (859) 257-2573

2050 Versailles Rd
Lexington, KY 40504
Phone (859) 254-5701

Interoperability endpoints

  • Direct secure messaging: dperry57871@ukhcdirect.org

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.

Hospital & facility affiliations 1

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": "1242432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538006400000",
    "number": "1639304942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 VERSAILLES RD",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405041405",
            "telephone_number": "859-257-4888",
            "fax_number": "859-323-1123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 S LIMESTONE STREET SUITE A100A",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405368202",
            "telephone_number": "859-257-2573",
            "fax_number": "859-323-0096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "DWAN",
        "middle_name": "ROZZEL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-16",
        "last_updated": "2018-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "VA",
            "license": "0102203436",
            "primary": false
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "KY",
            "license": "TP990",
            "primary": false
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "TN",
            "license": "2736",
            "primary": false
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "VA",
            "license": "0102203436",
            "primary": false
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "KY",
            "license": "04197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.