Individual provider Active NPI

Timothy Carlton Perry

  • Speech-Language Pathologist
  • Boston, MA
National Provider Identifier
1992501803
Registry record updated Feb 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP100570 Issued in MA
Practice address
185 Pilgrim Rd # Span106
Boston, MA 02215-5324
Phone
(860) 681-4163
NPI assigned
Feb 21, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SLP100570 MA Primary

Addresses

Primary practice location

185 Pilgrim Rd # Span106
Boston, MA 02215-5324

Mailing address

80 Revere St Apt 4
Boston, MA 02114-4419
Phone (860) 681-4163

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SLP100570MAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1740096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740096000000",
    "number": "1992501803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 REVERE ST APT 4",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021144419",
            "telephone_number": "860-681-4163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 PILGRIM RD # SPAN106",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155324",
            "telephone_number": "860-681-4163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "TIMOTHY",
        "middle_name": "CARLTON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-02-21",
        "last_updated": "2025-02-21",
        "certification_date": "2025-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MA",
            "license": "SLP100570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2025; 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.