NPIMap

Organization Active NPI

Perry Medical Clinic, P. C.

  • Family Medicine Physician
  • Centre, AL
National Provider Identifier
1982789251
Registry record updated Jan 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PERRY MEDICAL CLINIC, P. C.
Practice address
401 Northwood Dr
Centre, AL 35960-1022
Phone
(256) 927-3607
Fax
(256) 927-3605
NPI assigned
Oct 26, 2006
Last updated
Jan 30, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2023

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

Authorized official

Name
Jessica P Bakane
Title
Administrator
Phone
(205) 558-2525

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X AL Primary

Addresses

Primary practice location

401 Northwood Dr
Centre, AL 35960-1022

Mailing address

401 Northwood Dr
Centre, AL 35960-1022
Phone (256) 927-3607

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050715001012 AL Part B Supplier - Clinic/Group Practice 0345276770 Receives reassigned benefits from 6 practitioners
Practice locations: Centre, AL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
01D0665218Perry Medical Clinic PC401 Northwood Drive, Centre, AL 35960ComplianceMay 4, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675036800000",
    "number": "1982789251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 NORTHWOOD DR",
            "city": "CENTRE",
            "state": "AL",
            "postal_code": "359601022",
            "telephone_number": "256-927-3607",
            "fax_number": "256-927-3605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 NORTHWOOD DR",
            "city": "CENTRE",
            "state": "AL",
            "postal_code": "359601022",
            "telephone_number": "256-927-3607",
            "fax_number": "256-927-3605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERRY MEDICAL CLINIC, P. C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A",
        "authorized_official_last_name": "BAKANE",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "205-558-2525"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Other",
            "affiliation": "N",
            "address_1": "401 Northwood Dr",
            "city": "Centre",
            "state": "AL",
            "country_code": "US",
            "postal_code": "359601022",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Centre, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2023; 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.