Individual provider Active NPI

Jennifer Lynn Perreault

  • Physical Medicine & Rehabilitation Physician
  • Cumberland, RI
National Provider Identifier
1649840596
Registry record updated Jul 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
PTA01203 Issued in RI
Practice address
15 Sumner Brown Rd
Cumberland, RI 02864-1214
Phone
(401) 333-6352
NPI assigned
Jul 1, 2021
Last updated
Jul 1, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X PTA01203 RI Primary

Addresses

Primary practice location

15 Sumner Brown Rd
Cumberland, RI 02864-1214

Mailing address

44 Capron Farm Dr
Warwick, RI 02886-7702
Phone (979) 299-9349

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
PTA01203RIMDPhysical Medicine & Rehabilitation Physician

NPI Registry JSON

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

{
    "created_epoch": "1625097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625097600000",
    "number": "1649840596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 CAPRON FARM DR",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028867702",
            "telephone_number": "979-299-9349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 SUMNER BROWN RD",
            "city": "CUMBERLAND",
            "state": "RI",
            "postal_code": "028641214",
            "telephone_number": "401-333-6352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERREAULT",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-01",
        "last_updated": "2021-07-01",
        "certification_date": "2021-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "RI",
            "license": "PTA01203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumberland, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 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.