Active NPI
Mary Jo Perley, NP
- Psychiatric/Mental Health Nurse Practitioner
- San Antonio, TX
National Provider Identifier
1740470368
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 565494
- Practice address
- 4502 Medical Dr
San Antonio, TX 78229-4402 - Phone
- (210) 358-0594
- Fax
- (210) 358-2135
- NPI assigned
- Jul 30, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 565494 | TX | Primary |
Addresses
Primary practice location
4502 Medical Dr
San Antonio, TX 78229-4402
Mailing address
PO Box 87
San Antonio, TX 78291-0087
Phone (210) 358-9172
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8Y2633 | Other | TX | BCBS |
| P00600828 | Other | TX | RAILROAD MEDICARE |
| 191830201 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pain Management Specialists | Past | Accepting new patients | |
| Community Medicine Associates | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Family Medicine Physician
- San Antonio, TX
- NPI 1245313329
-
- Interventional Pain Medicine Physician
- San Antonio, TX
- NPI 1922617125
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1185753600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1374451200000",
"number": "1740470368",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 87",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782910087",
"telephone_number": "210-358-9172",
"fax_number": "210-358-9183"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4502 MEDICAL DR",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782294402",
"telephone_number": "210-358-0594",
"fax_number": "210-358-2135"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PERLEY",
"first_name": "MARY",
"middle_name": "JO",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-07-30",
"last_updated": "2013-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "TX",
"license": "565494",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "8Y2633",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00600828",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "191830201",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.