Active NPI
Jack Perryman
- Professional Counselor
- Blakely, GA
National Provider Identifier
1992992184
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC002515
- Practice address
- 2063 S Main St
Blakely, GA 39823-2267 - Phone
- (229) 430-4002
- NPI assigned
- Oct 2, 2007
- Last updated
- Oct 2, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC002515 | Primary |
Addresses
Primary practice location
2063 S Main St
Blakely, GA 39823-2267
Mailing address
1120 W Broad Ave
Albany, GA 31707-4397
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Albany Area Community SVC. Board | Past | Accepting new patients | |
| Albany Area Community Service Board | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Public Health or Welfare Agency
- Blakely, GA
- NPI 1447307400
-
- Public Health or Welfare Agency
- Albany, GA
- NPI 1063464212
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1191283200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1191283200000",
"number": "1992992184",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1120 W BROAD AVE",
"city": "ALBANY",
"state": "GA",
"postal_code": "317074397"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2063 S MAIN ST",
"city": "BLAKELY",
"state": "GA",
"postal_code": "398232267",
"telephone_number": "229-430-4002"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PERRYMAN",
"first_name": "JACK",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-10-02",
"last_updated": "2007-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": null,
"license": "LPC002515",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Blakely, GA
- Donna Lashawn Mells-McCoy
- Mike's Pharmacy, Inc
- Michelle Mock, RN
- Luis Alberto Murrain, D.O.
- Samantha Peckham, AT, ATC
- Pioneer Community Hospital of Early
- Pioneer Health Services of Early County LLC (Pioneer Community Hospital of Early)
- Pioneer Health Services of Early County, LLC (Pioneer Community Hospital of Early)
- Pioneer Health Services of Early County, LLC
- Pioneer Health Services of Early County, LLC (Pioneer Family Care)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.