Individual provider Active NPI

Terry I Neal, FNP-C

  • Family Nurse Practitioner
  • Wabash, IN
National Provider Identifier
1053306712
Registry record updated Nov 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71000182 Issued in IN
Practice address
276 Manchester Ave
Wabash, IN 46992-1808
Phone
(260) 563-2126
Fax
(260) 563-2120
NPI assigned
Sep 19, 2005
Last updated
Nov 28, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71000182 IN Primary
Primary Care Nurse Practitioner 363LP2300X 71008383 IN

Addresses

Primary practice location

276 Manchester Ave
Wabash, IN 46992-1808

Mailing address

276 Manchester Ave
Wabash, IN 46992-1808
Phone (260) 563-2126

Other identifiers 2

IdentifierTypeStateIssuer
000000781881OtherINANTHEM
200116740MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address terry.nealfnp.p77@direct.ahni.nextgenshare.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111118000119 IN Practitioner - Nurse Practitioner 4385818863 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1320 W Spencer Ave
Marion, IN 46952-3415
Phone (765) 613-0111

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
71000182INMDFamily Nurse Practitioner
71008383INMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
American Health Network of Indiana, LLC Past Accepting new patients
Earnest Associates Inc Past Accepting new patients
Marion General Hospital PastSince Sep 1, 2012 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: terry.nealfnp.p77@direct.ahni.nextgenshare.com
  • Direct secure messaging: tneal191368@direct.optum.com

Organizations & group practices 4

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1127088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701129600000",
    "number": "1053306712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "276 MANCHESTER AVE",
            "city": "WABASH",
            "state": "IN",
            "postal_code": "469921808",
            "telephone_number": "260-563-2126",
            "fax_number": "260-563-2120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "276 MANCHESTER AVE",
            "city": "WABASH",
            "state": "IN",
            "postal_code": "469921808",
            "telephone_number": "260-563-2126",
            "fax_number": "260-563-2120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEAL",
        "first_name": "TERRY",
        "middle_name": "I",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-19",
        "last_updated": "2023-11-28",
        "certification_date": "2023-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71000182",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "IN",
            "license": "71008383",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000781881",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200116740",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "terry.nealfnp.p77@direct.ahni.nextgenshare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1320 W Spencer Ave",
            "city": "Marion",
            "state": "IN",
            "country_code": "US",
            "postal_code": "469523415",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wabash, IN

Sources for this page

Verify at the official NPI Registry.