Phil C Perry, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

ME46225 Issued in FL

Practice address

1 Shircliff Way
Suite 1302
Jacksonville, FL 32204-4748

Phone

(904) 308-7420

NPI assigned

Sep 13, 2005

Last updated

Mar 10, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299715200000",
    "number": "1730174038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5102 YACHT CLUB RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322108324",
            "telephone_number": "904-387-5163",
            "fax_number": "904-387-5651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SHIRCLIFF WAY",
            "address_2": "SUITE 1302",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044748",
            "telephone_number": "904-308-7420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "PHIL",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-13",
        "last_updated": "2011-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "ME46225",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00427215A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "041595200",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "15980",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melody Perry
• Michael Edward Perry, PA-C
• Morgan Joanne Perry, NP
• Nathan Perry Jr., M.D.
• Noel Masters Perry
• Stephanie Perry, RD
• Susan Perry, R.PH. C.PH.
• Tasha Perry
• Whitney Perry
• Paula Leigh Perryman, CRNA

• Anesthesiology Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Anesthesiology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2011; 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.