NPIMap

Individual provider Active NPI

Robert Elvie Perry, M.D.

  • Internal Medicine Physician
  • Cape Girardeau, MO
National Provider Identifier
1659376234
Registry record updated Mar 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
R3H52 Issued in MO
Practice address
1701 Lacey St
Cape Girardeau, MO 63701-5230
Phone
(573) 331-6353
Fax
(573) 331-6378
NPI assigned
Jun 20, 2005
Last updated
Mar 9, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2015

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 R3H52 MO Primary

Addresses

Primary practice location

1701 Lacey St
Cape Girardeau, MO 63701-5230

Mailing address

343 Graphite LN
Cape Girardeau, MO 63701-9148
Phone (573) 651-3259

Other identifiers 1

IdentifierTypeStateIssuer
202468104MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, FL2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20080409000620 MO Practitioner - Internal MedicinePractitioner - Emergency Medicine 2264519651 Reassigns benefits to 4 organizations
I20181003000380 FL Practitioner - Internal Medicine 2264519651 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Maryland School of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Missouri Delta Medical CenterGroup PAC ID 1355252891, 134 clinicians

Practice addresses (Care Compare)

1008 N Main St
Sikeston, MO 63801-5044
Phone (573) 471-1600

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital Perry Current Accepting new patients
Southland EMS at Weems PL CurrentSince Jul 26, 2018 Accepting new patients
Mercy Hospital Perry CurrentSince Oct 1, 2023 Accepting new patients
Pemiscot County Memorial Hospital CurrentSince Jun 15, 2020 Accepting new patients
Missouri Delta Medical Center Internal Medicine CurrentSince Dec 30, 2013 Accepting new patients
Missouri Delta Medical Center CurrentSince Dec 30, 2013 Accepting new patients
Pemiscot County Memorial Hospital CurrentSince Jun 15, 2020 Accepting new patients
Mercy Hospital Perry CurrentSince Oct 1, 2023 Accepting new patients
Southland Hospitalist at Weems PL CurrentSince Jul 26, 2018 Accepting new patients
Mineral Area Osteopathic Hospital Inc Internal Medicine Past Accepting new patients
Dexter Emergency Physicians, LLC Past Accepting new patients
Medstop One Inc PastSince Apr 26, 2018 Accepting new patients
Bariatric & Metabolic Institute LLC PastSince Aug 6, 2019 Accepting new patients
Missouri Delta Medical Center Past Accepting new patients

Locations

135 Avenue G
Apalachicola, FL 32320
Phone (850) 653-8853

946 E Reed St
Hayti, MO 63851
Phone (573) 359-3408

434 N West St
Perryville, MO 63775
Phone (573) 547-2530

1008 N Main St
Sikeston, MO 63801
Phone (573) 471-1600

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1119225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425859200000",
    "number": "1659376234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "343 GRAPHITE LN",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637019148",
            "telephone_number": "573-651-3259",
            "fax_number": "573-332-0206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 LACEY ST",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637015230",
            "telephone_number": "573-331-6353",
            "fax_number": "573-331-6378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "ROBERT",
        "middle_name": "ELVIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-20",
        "last_updated": "2015-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "R3H52",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "202468104",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Girardeau, MO

Sources for this page

Verify at the official NPI Registry.