Jack R Perry, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036.138175 Issued in IL

Practice address

Walker Baptist Hospital
3400 Hwy 78 E
Jasper, AL 35501

Phone

(205) 387-4000

NPI assigned

Jul 13, 2005

Reactivated

Mar 22, 2006

Last updated

Mar 7, 2019By 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 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in KY, AL2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Baptist Health Centers, LLC

  dba Baptist Health Medical Group

  • Health Service Clinic/Center
  • Winfield, AL
  • NPI 1265496236
  Medicare reassignment NPD
• Imc-Hospitalists LLC

  • Hospitalist Physician
  • Mobile, AL
  • NPI 1669824934
  Medicare reassignment NPD
• Southeastern Physician Services PC

  • Hospitalist Physician
  • Oak Ridge, TN
  • NPI 1083835441

  Internal Medicine, KY

  Medicare reassignment NPD
• Baptist Health Centers LLC

  dba Baptist Health Medical Group

  • Specialist
  • Talladega, AL
  • NPI 1669436721
  NPD
• Kentucky Inpatient Medicine Associates, PLLC

  • Hospitalist Physician
  • Lexington, KY
  • NPI 1417915661

  Internal Medicine

  NPD (past)
• Kentuckyone Health Medical Group, Inc.

  dba CHI Saint Joseph Medical Group

  • Family Medicine Physician
  • Lexington, KY
  • NPI 1104875970

  Internal Medicine

  NPD (past)
• Marshall Emergency Services Associates, PLLC

  • Emergency Medicine Physician
  • Lexington, KY
  • NPI 1891737185
  NPD (past)
• Northwest Florida Primary Care LLC

  • Hospitalist Physician
  • Niceville, FL
  • NPI 1740429679
  NPD (past)
• Western Baptist Medical Ventures, Inc.

  dba Paducah Neurosurgical Center

  • Neurological Surgery Physician
  • Paducah, KY
  • NPI 1316017080
  NPD (past)

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

{
    "created_epoch": "1121212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551916800000",
    "number": "1851399877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "WALKER BAPTIST HOSPITAL",
            "address_2": "3400 HWY 78 E",
            "city": "JASPER",
            "state": "AL",
            "postal_code": "35501",
            "telephone_number": "205-387-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "WALKER BAPTIST HOSPITAL",
            "address_2": "3400 HWY 78 E",
            "city": "JASPER",
            "state": "AL",
            "postal_code": "35501",
            "telephone_number": "205-387-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "JACK",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-13",
        "last_updated": "2019-03-07",
        "deactivation_date": "2006-03-16",
        "reactivation_date": "2006-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036.138175",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "34733",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036.138175",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64347339",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P01183981",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pathway Camp Mitnick LLC
• Allie Patterson
• Barbara H Paulman, MLT,ASCP
• Bridget Perkins, MA
• Ashley Nicole Perry, ALC
• Sonja Pettus, M.D.
• Tin Thanh Pham
• Hailey Brooke Phillips, OTR/L
• Leanna Michelle Phillips, NP
• C Renee Philpot-Bowen, DC

• Internal Medicine Physician in Jasper, AL
• Providers in Jasper, AL by specialty
• Internal Medicine Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2019; 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.