Active NPI
Thomas Russell Perry, M.D.
- Neurology Physician
- Fort Atkinson, WI
National Provider Identifier
1922280403
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 22619
- Practice address
- 611 Sherman Ave E
Fort Atkinson, WI 53538-1960 - Phone
- (920) 568-5334
- NPI assigned
- Nov 27, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | 22619 | WI | Primary |
Addresses
Primary practice location
611 Sherman Ave E
Fort Atkinson, WI 53538-1960
Mailing address
2229 15TH St
Monroe, WI 53566-2116
Phone (608) 325-6664
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 31804600 | Medicaid | WI | |
| 569574 | Other | WI | DEAN HEALTH PLAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22619 | WI | MD | Neurology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thomas R. Perry, M.D.,S.C. | Neurology | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Neurology Physician
- Fort Atkinson, WI
- NPI 1013065598
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1196121600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211760000000",
"number": "1922280403",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2229 15TH ST",
"city": "MONROE",
"state": "WI",
"postal_code": "535662116",
"telephone_number": "608-325-6664",
"fax_number": "608-299-3745"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "611 SHERMAN AVE E",
"city": "FORT ATKINSON",
"state": "WI",
"postal_code": "535381960",
"telephone_number": "920-568-5334"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PERRY",
"first_name": "THOMAS",
"middle_name": "RUSSELL",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-11-27",
"last_updated": "2008-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "WI",
"license": "22619",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "31804600",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEAN HEALTH PLAN",
"identifier": "569574",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Atkinson, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.