Kevin Woodson Perris, PT

Primary specialty

Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X

License

20117 Issued in PA

Practice address

900 Wildflower Cir Ste 903
Washington, PA 15301-9782

Phone

(724) 416-7172

Fax

(724) 416-3037

NPI assigned

Jun 18, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in PA, WV2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Crossroads Physical Therapy PCGroup PAC ID 5799057071, 2 clinicians

Practice addresses (Care Compare)

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.

• Crossroads Physical Therapy, PC

  • Physical Therapist
  • Washington, PA
  • NPI 1437690021

  WV

  Medicare reassignment Care Compare group NPD Authorized official
• Country Roads Physical Therapy and Rehabilitation

  • Physical Therapist
  • Fairmont, WV
  • NPI 1831147297
  NPD
• Tudor Home Therapies Inc

  dba Tudor Physical Therapy Centers

  • Physical Therapist
  • Austintown, OH
  • NPI 1295783389
  NPD (past)

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

{
    "created_epoch": "1182124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633392000000",
    "number": "1972708295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 WILDFLOWER CIR",
            "address_2": "STE 903",
            "city": "WASHINGTON",
            "state": "PA",
            "postal_code": "153019782",
            "telephone_number": "724-416-3037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 WILDFLOWER CIR STE 903",
            "city": "WASHINGTON",
            "state": "PA",
            "postal_code": "153019782",
            "telephone_number": "724-416-7172",
            "fax_number": "724-416-3037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRIS",
        "first_name": "KEVIN",
        "middle_name": "WOODSON",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-18",
        "last_updated": "2021-10-05",
        "certification_date": "2021-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "PA",
            "license": "002197",
            "primary": false
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "OH",
            "license": "10071",
            "primary": false
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "PA",
            "license": "20117",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WV STATE LICENSE",
            "identifier": "002987",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA STATE LICENSE",
            "identifier": "020117",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pennsylvania Elks Major Projects, Inc.
• Selina Rae Penvose
• Abelardo Perez, LAPC
• Perfect Smile Dental of Washington, LLC
• Marie S. Perkins, R.N., CRNA
• Amanda Lee Perryman, LSW
• Margaret Peters, PT
• Alycia Ann Petraglia, D.O.
• Bridgette Lauren Petras, MS, CAADC, LPC
• Natalie Petrosky

• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Washington, PA
• Providers in Washington, PA by specialty
• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.