Active NPI
Susan J Perry, NP
- Women's Health Nurse Practitioner
- Fall River, MA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Women's Health Nurse Practitioner
- License
- 110333
- Practice address
- 373 New Boston Road
Fall River, MA 02720-5814 - Phone
- (508) 679-0911
- Fax
- (508) 536-0310
- NPI assigned
- Sep 5, 2006
- Last updated
- Oct 12, 2012
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Women's Health Nurse Practitioner | 363LW0102X | 110333 | MA | Primary |
| Obstetrics & Gynecology Nurse Practitioner | 363LX0001X | 110333 | MA |
Addresses
Primary practice location
373 New Boston Road
Fall River, MA 02720-5814
Mailing address
373 New Boston Road
Fall River, MA 02720-5814
Phone (508) 679-0911
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NP2308 | Other | MA | BCBS |
| 0321443 | Medicaid | MA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060130000569 | MA | Practitioner - Nurse Practitioner | 2062426091 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 110333 | MA | MD | Women's Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| GYN-OB Associates Inc | Current | Accepting new patients |
Locations
235 Hanover St
Fall River, MA 02720
Phone (508) 646-9525
235 Hanover St
Ste 305
Fall River, MA 02720
Phone (508) 677-0700
373 New Boston Rd
Fall River, MA 02720
Phone (508) 679-0054
373 New Boston Rd
Ste 2
Fall River, MA 02720
Phone (508) 679-0911
Interoperability endpoints
- sperry@gynob.emadirect.md
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Medical Specialty Clinic/Center
- Fall River, MA
- NPI 1215009196
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157414400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1350000000000",
"number": "1780786038",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "373 NEW BOSTON ROAD",
"city": "FALL RIVER",
"state": "MA",
"postal_code": "027205814",
"telephone_number": "508-679-0911",
"fax_number": "508-536-0310"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "373 NEW BOSTON ROAD",
"city": "FALL RIVER",
"state": "MA",
"postal_code": "027205814",
"telephone_number": "508-679-0911",
"fax_number": "508-536-0310"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PERRY",
"first_name": "SUSAN",
"middle_name": "J",
"name_prefix": "Ms.",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-05",
"last_updated": "2012-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "363LW0102X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Women's Health",
"state": "MA",
"license": "110333",
"primary": true
},
{
"code": "363LX0001X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Obstetrics & Gynecology",
"state": "MA",
"license": "110333",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "NP2308",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0321443",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fall River, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.