Individual provider Active NPI

Kristin Perry

  • Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
  • Alexandria, VA
National Provider Identifier
1639849508
Registry record updated Sep 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery Within the Head and Neck (Plastic Surgery) PhysicianTaxonomy code 2082S0099X
License
0110007981 Issued in VA
Practice address
5250 Cherokee Ave Ste 301
Alexandria, VA 22312-2052
Phone
(703) 647-2762
NPI assigned
Sep 14, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician 2082S0099X 0110007981 VA Primary

Addresses

Primary practice location

5250 Cherokee Ave Ste 301
Alexandria, VA 22312-2052

Mailing address

3030 Jehossee St Apt 104
Raleigh, NC 27616-5936
Phone (615) 557-2509

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0110007981VAMDPlastic Surgery Within the Head and Neck (Plastic Surgery) Physician

NPI Registry JSON

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

{
    "created_epoch": "1631577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631577600000",
    "number": "1639849508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3030 JEHOSSEE ST APT 104",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276165936",
            "telephone_number": "615-557-2509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5250 CHEROKEE AVE STE 301",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223122052",
            "telephone_number": "703-647-2762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "KRISTIN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-14",
        "last_updated": "2021-09-14",
        "certification_date": "2021-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2082S0099X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Plastic Surgery Within the Head and Neck",
            "state": "VA",
            "license": "0110007981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.