Individual provider Active NPI

Tamika L Perry, D.O.

  • Family Medicine Physician
  • Desoto, TX
National Provider Identifier
1649237710
Registry record updated Jun 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
L9847 Issued in TX
Practice address
935 York Dr
Desoto, TX 75115-2043
Phone
(972) 591-0954
Fax
(972) 805-9016
NPI assigned
May 1, 2006
Last updated
Jun 14, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X L9847 TX Primary

Addresses

Primary practice location

935 York Dr
Desoto, TX 75115-2043

Mailing address

935 York Dr
Desoto, TX 75115-2043
Phone (972) 591-0954

Other identifiers 2

IdentifierTypeStateIssuer
180626701MedicaidTX
180626702MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20060718000331 TX Practitioner - Family Practice 5395758270 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wellmed Medical Group PAGroup PAC ID 4880657386, 666 clinicians

Practice addresses (Care Compare)

3107 W Camp Wisdom Rd
Suite 170 Wellmed at Redbird Square
Dallas, TX 75237-2643
Phone (972) 942-7700

6157 NW Loop 410
124 Wellmed at Ingram Park
San Antonio, TX 78238-3302
Phone (210) 523-1411

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmed Medical Group, PA Family Medicine Current Accepting new patients
Wellmed Medical Group, P.a. Family Medicine CurrentSince Dec 17, 2018 Accepting new patients
Wellmed Medical Group, P.a. Family Medicine CurrentSince Dec 17, 2018 Accepting new patients
Ipc Pac Healthcare Services of Texas PLLC Family Medicine Past Accepting new patients
Redbird Wellness PLLC Family Medicine PastSince Nov 30, 2013 Accepting new patients
Waterstone Wellness, PLLC Past Accepting new patients
Tamika L Perry, D.O., P.a. PastSince Apr 13, 2006 Accepting new patients

Locations

3107 W Camp Wisdom Rd
Ste 170
Dallas, TX 75237
Phone (972) 942-7700

6157 NW Loop 410
Ste 124
San Antonio, TX 78238
Phone (210) 523-1411

8637 Fredericksburg Rd
Ste 360
San Antonio, TX 78240
Phone (210) 304-3500

Interoperability endpoints

  • Direct secure messaging: tamika.perry@wellmed.eclinicaldirectplus.com

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465862400000",
    "number": "1649237710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "935 YORK DR",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751152043",
            "telephone_number": "972-591-0954",
            "fax_number": "972-805-9016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "935 YORK DR",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751152043",
            "telephone_number": "972-591-0954",
            "fax_number": "972-805-9016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "TAMIKA",
        "middle_name": "L",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-01",
        "last_updated": "2016-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "L9847",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "180626701",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "180626702",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Desoto, TX

Sources for this page

Verify at the official NPI Registry.