Jon E Perry, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA2011-0062 Issued in NM

Practice address

1700 N Union Ave
Roswell, NM 88201-3267

Phone

(575) 489-4750

Fax

(575) 586-4414

NPI assigned

Oct 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Mind & Body Healthcare LLC

  • Clinic/Center
  • Roswell, NM
  • NPI 1770122277
  NPD Authorized official
• Decatur Emergency Medical Services II S C

  • Emergency Medical Services (Emergency Medicine) Physician
  • Decatur, IL
  • NPI 1699881508
  NPD (past)

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577923200000",
    "number": "1740376102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "714 GARDEN PL",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882017767",
            "telephone_number": "575-489-4750",
            "fax_number": "575-586-4414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 N UNION AVE",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882013267",
            "telephone_number": "575-489-4750",
            "fax_number": "575-586-4414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "JON",
        "middle_name": "E",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2020-01-02",
        "certification_date": "2020-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA22153",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085-002088",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "ID",
            "license": "PA-848",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": "PA2011-0062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristin Peralta, LSAA
• Cheyann Perez
• Katheryne Perez
• Kimberly Kay Perez, MA CCC-SLP
• Tasha Perez, PTA
• Peter Bailey MD PA
• Eric Yancey Peterson, M.D.
• Yukie Ebara Pfeuffer, MED MS
• Amanda D'Layne Phillips, OTR
• Robert Owen Phillips, DBH, LMSW, LADAC

• Physician Assistant in Roswell, NM
• Providers in Roswell, NM by specialty
• Physician Assistant in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.