Individual provider Active NPI

Susan J Perry, NP

  • Women's Health Nurse Practitioner
  • Fall River, MA
National Provider Identifier
1780786038
Registry record updated Oct 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
110333 Issued in MA
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, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
NP2308OtherMABCBS
0321443MedicaidMA

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060130000569 MA Practitioner - Nurse Practitioner 2062426091

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
110333MAMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
GYN-OB Associates Inc CurrentSince Jan 27, 2000 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

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.