Madelon Carol Perkins, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

250714 Issued in AZ

Practice address

12707 W Caraveo PL
Peoria, AZ 85383-8067

Phone

(623) 810-9659

NPI assigned

Dec 9, 2020

Last updated

Dec 9, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Madelon Carol Evenson Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1607472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607472000000",
    "number": "1952907479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12707 W CARAVEO PL",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853838067",
            "telephone_number": "623-810-9659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12707 W CARAVEO PL",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853838067",
            "telephone_number": "623-810-9659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERKINS",
        "first_name": "MADELON",
        "middle_name": "CAROL",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-09",
        "last_updated": "2020-12-09",
        "certification_date": "2020-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "250714",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVER LICENSE",
            "identifier": "D01467208",
            "state": "AZ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Peoria",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "n/a",
            "address_1": "12707 W Caraveo Pl",
            "city": "Peoria",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "853838067",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MADELON",
            "last_name": "EVENSON",
            "middle_name": "CAROL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Leslie A Perez-Whitehead, MSW, LCSW
• Madai Perez, DMD
• Sierra Perez
• Perfect Teeth - Olive P.C.
• Perkins Dental, PLLC
• Vaughn E. Perkins III, DMD
• Brian Harris Perlmutter, M.D.
• Shanikka Perryman
• Geoffrey Thomas Pesanka, PHARMD
• Pet Scan Arizona LLC

• Family Nurse Practitioner in Peoria, AZ
• Providers in Peoria, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.