Jennings Michael Perry, DNP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

20499 Issued in SC

Practice address

1301 48TH Ave N # a-2
Myrtle Beach, SC 29577-5427

Phone

(843) 855-2299

NPI assigned

May 26, 2011

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

Medicare fee-for-service enrollment

Enrolled in SC

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

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 and National Provider Directory roles.

• Acs Primary Care Physicians - Southeast PC

  • Emergency Medicine Physician
  • Myrtle Beach, SC
  • NPI 1861430555
  Medicare reassignment NPD
• Revived Vitality

  • Clinic/Center
  • Myrtle Beach, SC
  • NPI 1992588750
  NPD Authorized official

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

{
    "created_epoch": "1306368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1851684674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "728 CONIFER CT",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724172",
            "telephone_number": "614-203-3515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 48TH AVE N # A-2",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295775427",
            "telephone_number": "843-855-2299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "JENNINGS",
        "middle_name": "MICHAEL",
        "credential": "DNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-05-26",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "353367",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "17756",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "SC",
            "license": "20499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Ines Pereyra Heyward, FNP-C
• Ivana Perez, PA-C
• David Robert Kenneth Perkins, MD
• Bobby B. Perry Jr., P.T.A.
• Devin A Perry, M.S.
• Matthew Alan Peterman, DO
• Amy Peterson
• Barbara Peterson, S.L.P.
• Alexander Petkovsek
• Thomas William Petrusick, MD

• Primary Care Nurse Practitioner in Myrtle Beach, SC
• Providers in Myrtle Beach, SC by specialty
• Primary Care Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2025; 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.