Melissa Adele Wren Perry, NP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

61139 Issued in ID

Practice address

300 S 23Rd St
Boise, ID 83702-9100

Phone

(208) 344-3512

Fax

(208) 466-5359

NPI assigned

Jul 16, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Addie Perry Other name

Medicare fee-for-service enrollment

Enrolled in ID, OR2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts, 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.

• Onepeak Southern Oregon PC

  • Family Medicine Physician
  • Medford, OR
  • NPI 1740917558
  Medicare reassignment NPD
• BHG Lxxxvii, LLC

  dba BHG Medical Services - Idaho

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Boise, ID
  • NPI 1194435123
  Medicare reassignment
• Center for Behavioral Health Idaho, LLC

  • Community/Behavioral Health Agency
  • Boise, ID
  • NPI 1760738645
  NPD (past)
• Saint Francis Medical Center

  • Internal Medicine Physician
  • Cape Girardeau, MO
  • NPI 1578513016
  NPD (past)

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

{
    "created_epoch": "1563235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710288000000",
    "number": "1902459266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836530009",
            "telephone_number": "208-467-4431",
            "fax_number": "208-466-5359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 S 23RD ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837029100",
            "telephone_number": "208-344-3512",
            "fax_number": "208-466-5359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "MELISSA",
        "middle_name": "ADELE WREN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-16",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "ID",
            "license": "61139",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "ID",
            "license": "61139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ADDIE",
            "last_name": "PERRY",
            "credential": "MSN, APRN, AGNP-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Alvin Paul Perry III, M.D.
• Barbara Lee Perry, R.D.
• Catherine Andrea Perry, MD
• D Kirk Perry
• Judith M Perry, NP
• Sherena Ann Perry, D.O., M.A.
• Tushia Philicia Perry, PHARMD
• Kristin Person Staley
• April Person
• Melanie Al Person

• Gerontology Nurse Practitioner in Boise, ID
• Providers in Boise, ID by specialty
• Gerontology Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2024; 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.