Individual provider Active NPI

Terry C Wellman, CRNA

  • Certified Registered Nurse Anesthetist
  • Hickory, NC
National Provider Identifier
1013997402
Registry record updated Feb 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
107447 Issued in NC
Practice address
10 3Rd Ave NE Ste 200
Hickory, NC 28601-5044
Phone
(828) 327-8105
Fax
(828) 327-4245
NPI assigned
Jan 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 107447 NC Primary

Addresses

Primary practice location

10 3Rd Ave NE Ste 200
Hickory, NC 28601-5044

Mailing address

415 N Center St
Ste 201
Hickory, NC 28601-5036
Phone (828) 327-8105

Other identifiers 1

IdentifierTypeStateIssuer
8049998MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041002000078 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 1355310616 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolina Anesthesia Associates PAGroup PAC ID 1456251057, 67 clinicians

Practice addresses (Care Compare)

2424 Century PL SE
Hickory, NC 28602-4031
Phone (828) 322-2050

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
107447NCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
East Carolina Anesthesia Associates, PLLC Anesthesiology CurrentSince Apr 1, 2017 Accepting new patients
Carolina Regional Anesthesia PLLC Anesthesiology CurrentSince Apr 1, 2023 Accepting new patients
Carolina Anesthesia Associates PA Anesthesiology CurrentSince Apr 1, 2023 Accepting new patients
Nurse Anesthesia of North Carolina, PLLC Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

3312 Battleground Ave
Greensboro, NC 27410
Phone (336) 282-5000

2430 Emerald Pl
Ste 103
Greenville, NC 27834
Phone (252) 752-2140

2424 Century Pl SE
Hickory, NC 28602
Phone 82832220506722

415 N Center St
Ste 201
Hickory, NC 28601

321 Mulberry St SW
Lenoir, NC 28645
Phone (828) 757-5100

5115 Oleander Dr
Wilmington, NC 28403
Phone (910) 362-1011

Organizations & group practices 5

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": "1137715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580860800000",
    "number": "1013997402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 N CENTER ST",
            "address_2": "STE 201",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286015036",
            "telephone_number": "828-327-8105",
            "fax_number": "828-327-4245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 3RD AVE NE STE 200",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286015044",
            "telephone_number": "828-327-8105",
            "fax_number": "828-327-4245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLMAN",
        "first_name": "TERRY",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-20",
        "last_updated": "2020-02-05",
        "certification_date": "2020-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "107447",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8049998",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hickory, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.