Individual provider Active NPI

Regina Benai Perry, APN

  • Family Nurse Practitioner
  • Memphis, TN
National Provider Identifier
1982892634
Registry record updated Nov 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
12410 Issued in TN
Practice address
51 N Dunlap St
Memphis, TN 38105-4625
Phone
(901) 287-7337
Fax
(901) 266-6488
NPI assigned
Oct 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 12410 TN Primary

Addresses

Primary practice location

51 N Dunlap St
Memphis, TN 38105-4625

Mailing address

850 Poplar Ave BLDG 2
Memphis, TN 38105-4607

Other practice location 1

1535 Vann Dr
Jackson, TN 38305-2095
Phone (731) 984-9949

Other practice location 2

100 N Humphreys Blvd
Memphis, TN 38120-2146
Phone (901) 287-7337

Other identifiers 1

IdentifierTypeStateIssuer
1527895MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090109000259 TN Practitioner - Nurse Practitioner 7911060413 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
12410TNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Lebonheur Pediatric Specialists, Inc. CurrentSince Jul 1, 2015 Accepting new patients
Methodist Healthcare Community Care Associates CurrentSince Nov 15, 2008 Accepting new patients
Adult Primary Care of Memphis PC Past Accepting new patients

Locations

8035 Club Pkwy
Cordova, TN 38016
Phone (901) 758-6035

1535 Vann Dr
Jackson, TN 38305
Phone (731) 984-9944

850 Poplar Ave
Bldg 2
Memphis, TN 38105
Phone (901) 287-5594

8071 Winchester Rd
Memphis, TN 38125
Phone (901) 367-9001

100 N Humphreys Blvd
Memphis, TN 38120
Phone (901) 747-1800

1407 Union Ave
Ste 200
Memphis, TN 38104
Phone (901) 866-8360

Interoperability endpoints

  • Direct secure messaging: rperry32393@mlh.direct-ci.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1191888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605657600000",
    "number": "1982892634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 POPLAR AVE BLDG 2",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381054607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 N DUNLAP ST",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381054625",
            "telephone_number": "901-287-7337",
            "fax_number": "901-266-6488"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1535 Vann Dr",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "TN",
            "postal_code": "383052095",
            "country_code": "US",
            "telephone_number": "731-984-9949",
            "fax_number": "731-215-6995",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 N Humphreys Blvd",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381202146",
            "country_code": "US",
            "telephone_number": "901-287-7337",
            "fax_number": "901-266-6488",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PERRY",
        "first_name": "REGINA",
        "middle_name": "BENAI",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-09",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "12410",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1527895",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.