Kaylea Beth Perjak, CPNP-PC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

2020017475 Issued in MO

Practice address

1965 S Fremont Ave Ste 220
Springfield, MO 65804-2283

Phone

(417) 820-0280

NPI assigned

Jun 21, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mercy Clinic Springfield Communities

  • Family Medicine Physician
  • Springfield, MO
  • NPI 1245277631
  Medicare reassignment NPD
• Mercy Clinic Springfield Communities

  • Rural Health Clinic/Center
  • Willow Springs, MO
  • NPI 1972771657
  Medicare reassignment NPD
• Mercy Clinic Springfield Communities

  • Family Medicine Physician
  • Hollister, MO
  • NPI 1053350454
  NPD

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

{
    "created_epoch": "1592697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645488000000",
    "number": "1811513369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1965 S FREMONT AVE STE 220",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658042283",
            "telephone_number": "417-820-0280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1965 S FREMONT AVE STE 220",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658042283",
            "telephone_number": "417-820-0280"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3443 S National Ave",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MO",
            "postal_code": "658077308",
            "country_code": "US",
            "telephone_number": "417-269-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PERJAK",
        "first_name": "KAYLEA",
        "middle_name": "BETH",
        "credential": "CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-21",
        "last_updated": "2022-02-22",
        "certification_date": "2022-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MO",
            "license": "2020017475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sharon L Pennington, LPC
• Leah Peppard, PA
• Samantha Ann Perez, DDS
• Perfect Health LLC
• Performance Plus Medical Equipment
• Amber Perkins, PSYD
• Michael R Perkins, MSW, LCSW
• Ryan Benjamin Perkins, DC
• Brooke Allison Pernicek, PLPC
• Perpetual Health LLC Dba Skyn Weight Loss and Wellness

• Pediatric Nurse Practitioner in Springfield, MO
• Providers in Springfield, MO by specialty
• Pediatric Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2022; 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.

Verify at the official NPI Registry.