Individual provider Active NPI

Jean E Perez

  • Pharmacist
  • Everett, MA
National Provider Identifier
1801558358
Registry record updated Oct 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
27757 Issued in MA
Practice address
9 Hazel Park Ste B
Everett, MA 02149-2507
Phone
(617) 372-7742
NPI assigned
Oct 12, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 27757 MA Primary

Addresses

Primary practice location

9 Hazel Park Ste B
Everett, MA 02149-2507

Mailing address

9 Hazel Park Ste B
Everett, MA 02149-2507
Phone (617) 372-7742

Other identifiers 1

IdentifierTypeStateIssuer
PH27757OtherMALICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL 6173727742@tmomail.net Health Information Exchange (HIE)

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
27757MAMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1633996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633996800000",
    "number": "1801558358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 HAZEL PARK STE B",
            "city": "EVERETT",
            "state": "MA",
            "postal_code": "021492507",
            "telephone_number": "617-372-7742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 HAZEL PARK STE B",
            "city": "EVERETT",
            "state": "MA",
            "postal_code": "021492507",
            "telephone_number": "617-372-7742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "JEAN",
        "middle_name": "E",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-10-12",
        "last_updated": "2021-10-12",
        "certification_date": "2021-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MA",
            "license": "27757",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "PH27757",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "6173727742@tmomail.net",
            "affiliation": "N",
            "endpointDescription": "device",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "useOtherDescription": "csv",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "contentOtherDescription": "csv",
            "address_1": "9 Hazel Park Ste B",
            "city": "Everett",
            "state": "MA",
            "country_code": "US",
            "postal_code": "021492507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Everett, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2021; 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.