Individual provider Active NPI

Charles McCrory Perme, M.D.

  • Vascular & Interventional Radiology Physician
  • Ashland, KY
National Provider Identifier
1720197858
Registry record updated Apr 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
30415 Issued in KY
Practice address
2201 Lexington Ave
Ashland, KY 41101-2843
Phone
(606) 408-4000
Fax
(916) 533-0078
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 35063920 OH
Vascular & Interventional Radiology Physician 2085R0204X 30415 KY Primary

Addresses

Primary practice location

2201 Lexington Ave
Ashland, KY 41101-2843

Mailing address

2754 Solution Ctr
Chicago, IL 60677-2007
Phone (606) 864-9697

Other identifiers 5

IdentifierTypeStateIssuer
000000978917OtherKYANTHEM BCBS
64937030MedicaidKY
0991066MedicaidOH
300094914OtherOHRAILROAD MEDICARE
000000038020OtherOHANTHEM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, KY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20110201000132 OH Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 5698954030 Reassigns benefits to 1 organization
I20151211000122 KY Practitioner - Diagnostic Radiology 5698954030

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Interventional Radiology
Education
University of Cincinnati College of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tristate Img (Imaging Medical Group) IncGroup PAC ID 6204732365, 45 clinicians

Practice addresses (Care Compare)

375 Dixmyth Ave
Cincinnati, OH 45220-2475
Phone (513) 865-1331

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.01 of 100Reported as apm
Quality
86.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35063920OHMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tristate Img (Imaging Medical Group) Inc CurrentSince Sep 30, 2017 Accepting new patients

Locations

375 Dixmyth Ave
Cincinnati, OH 45220
Phone (513) 862-2432

10500 Montgomery Rd
Montgomery, OH 45242
Phone (513) 557-3206

Organizations & group practices 1

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459987200000",
    "number": "1720197858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2754 SOLUTION CTR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606772007",
            "telephone_number": "606-864-9697",
            "fax_number": "916-533-0078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 LEXINGTON AVE",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411012843",
            "telephone_number": "606-408-4000",
            "fax_number": "916-533-0078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERME",
        "first_name": "CHARLES",
        "middle_name": "MCCRORY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2016-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OH",
            "license": "35063920",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "KY",
            "license": "30415",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000978917",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64937030",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0991066",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "300094914",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000038020",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashland, KY

Sources for this page

Verify at the official NPI Registry.