Individual provider Active NPI

Jennifer H Perryman, MD

  • Dermatology Physician
  • Greeley, CO
National Provider Identifier
1891913372
Registry record updated Jan 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
0056904 Issued in CO
Practice address
6767 29TH St FL 3
Greeley, CO 80634-5474
Phone
(970) 652-2740
Fax
(970) 652-2733
NPI assigned
Apr 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X IP967 KY
Dermatology Physician 207N00000X 42464 KY
Dermatology Physician 207N00000X 01067334A IN
Dermatology Physician 207N00000X 0056904 CO Primary

Addresses

Primary practice location

6767 29TH St FL 3
Greeley, CO 80634-5474

Mailing address

6767 29TH St FL 3
Greeley, CO 80634-5474
Phone (970) 652-2740

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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 1

Enrollment IDStateProvider typePAC IDDetails
I20160620002087 CO Practitioner - Dermatology 2163572785 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Indiana University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

6767 29TH St
Greeley, CO 80634-5474
Phone (970) 224-3636

Hospital & facility affiliations

  • Uchealth Greeley Hospital Hospital, Greeley, CO, CCN 060131

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1407
Skin biopsy464

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0056904COMDDermatology Physician
01067334AINMDDermatology Physician
42464KYMDDermatology Physician
IP967KYMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Jan 31, 2022 Accepting new patients
Poudre Valley Medical Group, LLC Current Accepting new patients
University Medical Services Foundation Inc Past Accepting new patients
University Medical Associates Past Accepting new patients
Fort Collins Skin Clinic, P.C. Dermatology Past Accepting new patients

Locations

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

8890 N Union Blvd
Colorado Springs, CO 80920
Phone (719) 364-5633

6767 29th St
#3
Greeley, CO 80634

6767 29th St
Fl 3
Greeley, CO 80634
Phone (970) 652-2801

6767 29th St
Greeley, CO 80634
Phone (970) 652-2000

6767 29th St
Fl 2
Greeley, CO 80634
Phone (970) 652-2433

6767 29th St
Ste 3
Greeley, CO 80634

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643241600000",
    "number": "1891913372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6767 29TH ST FL 3",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806345474",
            "telephone_number": "970-652-2740",
            "fax_number": "970-652-2733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6767 29TH ST FL 3",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806345474",
            "telephone_number": "970-652-2740",
            "fax_number": "970-652-2733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRYMAN",
        "first_name": "JENNIFER",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-23",
        "last_updated": "2022-01-27",
        "certification_date": "2022-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "KY",
            "license": "IP967",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "KY",
            "license": "42464",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IN",
            "license": "01067334A",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CO",
            "license": "0056904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greeley, CO

Sources for this page

Verify at the official NPI Registry.