DERETSA PERRY NP
NPI 1881147692
Nurse Practitioner - Family in Johnson City, TN

Q: What is Deretsa Perry's NPI number?

The NPI number for Deretsa Perry is 1881147692. It was assigned to this individual provider in the NPPES registry on July 28, 2016.

Q: What is Deretsa Perry's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Deretsa Perry was last updated on February 21, 2017. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since July 28, 2016PECOS Enrolled

310 N STATE OF FRANKLIN RD, SUITE 400, JOHNSON CITY, TN 37604(423) 979-6000(423) 979-6011 Get Directions Write a Review

NPPES record last updated: February 21, 2017. Verified against the NPPES registry weekly; last sync: July 26, 2026.

On this page

About Deretsa Perry Np NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DERETSA PERRY NP (NPI 1881147692) is an individual family provider in Johnson City, Tennessee, licensed in Tennessee (21518) and active in the NPI registry since July 2016. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1881147692

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameDERETSA PERRYCredential: NP

Location Address310 N STATE OF FRANKLIN RD, SUITE 400Johnson City, TN 37604-6008

Mailing Address310 N State Of Franklin Rd, Suite 400Johnson City, TN 37604-6008 · (423) 979-6000 · Fax (423) 979-6011

Phone(423) 979-6000

Fax(423) 979-6011

Sole ProprietorNo

Enumeration DateJuly 28, 2016

Last NPPES UpdateFebruary 21, 2017

✔ NPI 1881147692 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in TN · 21518

310 N STATE OF FRANKLIN RD, Johnson City, TN 37604

Open in Google Maps ↗

Other Identifiers 3

MedicaidQ024107TN

Medicaid1881147692VA

Medicare PIN10350I4942TN

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Deretsa Perry Np is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 37604 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$81.53 typical visit price

range $52.64 – $160.89

Typical copayment $20.38 (range $13.16 – $40.22)

Most-billed visit code 99203

Established Patient

$93.60 typical visit price

range $16.72 – $131.41

Typical copayment $23.40 (range $4.18 – $32.85)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.