DR. JACQUELYN PERRY D.P.M. NPI 1346200649

NPI Information

NPI: 1346200649
Provider Name: DR. JACQUELYN PERRY, D.P.M.
Classification: Podiatrist - 213ES0131X
Entity Type: Individual

Specialization: Foot Surgery

PECOS Registration: Yes

Address:
3020 RACE ST
FORT WORTH, TX
ZIP 76111
Phone: (817) 838-9424
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DR. Jacquelyn Perry, D.P.M. is a foot surgery podiatrist in Fort Worth, TX with 34 years of experience. DR. Jacquelyn Perry, D.P.M. NPI is 1346200649. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: KENT STATE UNIVERSITY COLLEGE OF PODIATRIC MEDICINE
Graduation Year:1990

The provider's business location address is:

3020 RACE ST
FORT WORTH, TX
ZIP 76111-116
Phone: (817) 838-9424
Fax: (817) 838-9425

The NPI 1346200649 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 3/23/2006 and was last updated on 10/7/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	213ES0131X	Podiatrist	Foot Surgery	1244	TEXAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	621526786	OTHER	TEXAS	PACIFICARE/SECURE HORIZON
2	2097757	OTHER	TEXAS	AETNA HMO
3	018771801	MEDICAID	TEXAS
4	4407693	OTHER	TEXAS	AETNA PPO
5	621526786	OTHER	TEXAS	PHCS
6	480015334	MEDICARE ID-TYPE UNSPECIFIED	TEXAS	RAILROAD MEDICARE
7	621526786	OTHER	TEXAS	UNITED HEALTHCARE
8	00L64N	OTHER	TEXAS	BLUE CROSS BLUE SHEILD
9	U42519	MEDICARE UPIN	TEXAS
10	00L64N	MEDICARE ID-TYPE UNSPECIFIED	TEXAS
11	8F21962	MEDICARE PIN	TEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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