Individual provider Active NPI

Jade Reanna Perry, OTR

  • Occupational Therapist
  • Cody, WY
National Provider Identifier
1801490768
Registry record updated Jun 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Practice address
544 Yellowstone Ave
Cody, WY 82414-9300
Phone
(307) 587-9789
Fax
(307) 587-9787
NPI assigned
Nov 22, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X Primary

Addresses

Primary practice location

544 Yellowstone Ave
Cody, WY 82414-9300

Mailing address

544 Yellowstone Ave
Cody, WY 82414-9300
Phone (307) 587-9789

Other practice location 1

7985 Knight Rd
Gainesville, GA 30506-6427
Phone (770) 781-4899

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220629000825 WY Practitioner - Occupational Therapist in Private Practice 4082094602 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Canyon Hand Therapy, P.C.Group PAC ID 6901088020, 9 clinicians

Practice addresses (Care Compare)

544 Yellowstone Ave
Cody, WY 82414-9300
Phone (307) 587-9789

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Canyon Hand Therapy, P.C. CurrentSince Jul 11, 2022 Accepting new patients
Walker Therapy Services Occupational Therapist CurrentSince Nov 1, 2020 Accepting new patients

Locations

7985 Knight Rd
Gainesville, GA 30506
Phone (678) 467-7264

544 Yellowstone Ave
Cody, WY 82414
Phone (307) 587-9789

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, 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": "1606003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655251200000",
    "number": "1801490768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "544 YELLOWSTONE AVE",
            "city": "CODY",
            "state": "WY",
            "postal_code": "824149300",
            "telephone_number": "307-587-9789",
            "fax_number": "307-587-9787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "544 YELLOWSTONE AVE",
            "city": "CODY",
            "state": "WY",
            "postal_code": "824149300",
            "telephone_number": "307-587-9789",
            "fax_number": "307-587-9787"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7985 Knight Rd",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "GA",
            "postal_code": "305066427",
            "country_code": "US",
            "telephone_number": "770-781-4899",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PERRY",
        "first_name": "JADE",
        "middle_name": "REANNA",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-22",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cody, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.