Russell Edward Perry, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

52055 Issued in TN

Practice address

1231 Tusculum Blvd
Greeneville, TN 37745-4137

Phone

(423) 639-9970

Fax

(423) 639-4281

NPI assigned

Jun 15, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 1, 2019 through Jan 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Bert Fish Medical Center Inc

  • General Acute Care Hospital
  • New Smyrna Beach, FL
  • NPI 1245275734
  NPD (past)
• Southeast Volusia Medical Services Inc

  • Surgery Physician
  • New Smyrna Beach, FL
  • NPI 1104868876
  NPD (past)

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

{
    "created_epoch": "1118793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548720000000",
    "number": "1982609129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1231 TUSCULUM BLVD",
            "city": "GREENEVILLE",
            "state": "TN",
            "postal_code": "377454137",
            "telephone_number": "423-639-9970",
            "fax_number": "423-639-4281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1231 TUSCULUM BLVD",
            "city": "GREENEVILLE",
            "state": "TN",
            "postal_code": "377454137",
            "telephone_number": "423-639-9970",
            "fax_number": "423-639-4281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "RUSSELL",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-15",
        "last_updated": "2019-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "52055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cody Peeler, PHARMD
• Angela Michelle Penton, PTA
• Perfectly Tuned Chiropractic PLLC
• Jalesa Perkins
• Charles Stephen Perry, M.D.
• Person Centered Choices, LLC
• Pete and Marietta Vestal PTRS
• Michael James Philbeck, B.S.
• Vanessa Rae Phillips, MSW
• Ashlynn Danielle Pierce, LCSW

• Internal Medicine Physician in Greeneville, TN
• Providers in Greeneville, TN by specialty
• Internal Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2019; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.