Jesse Perry, M.D.

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

License

6644031-1205 Issued in UT

Practice address

777 Old Ranch Rd
Park City, UT 84098-6714

Phone

(435) 647-5900

NPI assigned

Mar 24, 2010

Last updated

Mar 24, 2010By 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 2

Addresses

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": "1269388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269388800000",
    "number": "1801110531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 OLD RANCH RD",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840986714",
            "telephone_number": "435-647-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 OLD RANCH RD",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840986714",
            "telephone_number": "435-647-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "JESSE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-03-24",
        "last_updated": "2010-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "UT",
            "license": "6644031-1205",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "UT",
            "license": "6644031-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Eugene Pellegrine, MD
• Vannette Perkins, MD
• Kristen Michelle Perlmutter, S.S.W.
• Adam Robert Perreault, MED, ATC
• James Robert Perrone, PTA
• Personal PT
• Donn W Peters, PSY.D.
• Mark William Peterson, DO
• Natasha Nicolle Peterson
• Pharmacy at Park City Clinic

• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Park City, UT
• Providers in Park City, UT by specialty
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2010; 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.