NPIMap

Individual provider Active NPI

Cynthia Anne Perry, M.D.

  • Internal Medicine Physician
  • Breckenridge, TX
National Provider Identifier
1710093497
Registry record updated Oct 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
K7591 Issued in TX
Practice address
2802 W Walker St
Breckenridge, TX 76424-4000
Phone
(254) 559-7215
Fax
(254) 559-7213
NPI assigned
Aug 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2012

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 K7591 TX Primary

Addresses

Primary practice location

2802 W Walker St
Breckenridge, TX 76424-4000

Mailing address

2802 W Walker St
Breckenridge, TX 76424-4000
Phone (254) 559-7215

Other identifiers 1

IdentifierTypeStateIssuer
29401902MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041015000365 TX Practitioner - Internal Medicine 7810957685 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Texas Tech University Health Science Center School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2802 W Walker St
Breckenridge, TX 76424-4000
Phone (254) 559-7215

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
K7591TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shackelford County Community Resource Center CurrentSince Feb 16, 2012 Accepting new patients
Shackelford County Community Resource Center CurrentSince Feb 16, 2012 Accepting new patients
Shackelford County Community Resource Center Past Accepting new patients
Childress County Hospital District Past Accepting new patients

Locations

725 Pate St
Albany, TX 76430
Phone (325) 762-2447

2802 W Walker St
Breckenridge, TX 76424
Phone (254) 559-7215

1712 N Access Rd
Clyde, TX 79510
Phone (325) 893-4010

301 S Main St
Cross Plains, TX 76443
Phone (254) 725-4311

217 Edwards
Merkel, TX 79536
Phone (325) 928-0014

Interoperability endpoints

  • Direct secure messaging: cynthia.perry.1@6815.direct.athenahealth.com
  • Direct secure messaging: cynthia.perry.1@28291.direct.athenahealth.com

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Resourcecare BairdBaird, TX, CCN 671909 Federally qualified health center Corporate Officer
W-2 Managing Employee		 Dec 8, 2014
Sep 12, 2011
Resourcecare BreckenridgeBreckenridge, TX, CCN 671831 Federally qualified health center W-2 Managing Employee Sep 12, 2011

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

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 9

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": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349136000000",
    "number": "1710093497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2802 W WALKER ST",
            "city": "BRECKENRIDGE",
            "state": "TX",
            "postal_code": "764244000",
            "telephone_number": "254-559-7215",
            "fax_number": "254-559-7213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2802 W WALKER ST",
            "city": "BRECKENRIDGE",
            "state": "TX",
            "postal_code": "764244000",
            "telephone_number": "254-559-7215",
            "fax_number": "254-559-7213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "CYNTHIA",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-22",
        "last_updated": "2012-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "K7591",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "29401902",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Breckenridge, TX

Sources for this page

Verify at the official NPI Registry.