Terrell Clinic LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN92056 Issued in TN

Legal business name

TERRELL CLINIC LLC

Practice address

701 East Reelfoot Ave
Suite 100
Union City, TN 38261

Phone

(731) 885-9687

Fax

(731) 885-6643

NPI assigned

Mar 10, 2008

Organization subpart

No

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

Authorized official

Name

Renea L Nagel-Terrell, CFNP-DNPNPI 1619977584

Title

Owner

Phone

(731) 885-9687

Specialties & licenses 2

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in TN2 enrollments

Enrollment records 2

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1053581744. Details of each certification follow.

• CCN 448916 Rural health clinic · Active · Details

Rural health clinic certification: CCN 448916

Legal name

TERRELL CLINIC, LLC

Certification status

Active

Provider type (POS)

Rural health clinic

Participating since

Sep 19, 2012

Last certification

Jan 22, 2025

Ownership / control type

1A

Organization structure

LLCProprietary

Incorporated

Mar 1, 2008 in TN

Enrollment address

701 East Reelfoot Avenue
Union City, TN 38261-0701

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Renea L Nagel-Terrell, CFNP

  • Family Nurse Practitioner
  • Union City, TN
  • NPI 1619977584

  5% Or Greater Direct Ownership Interest, Operational/Managerial Control, W-2 Managing Employee

  CMS ownership

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Renea L Nagel-Terrell, CFNP

  • Family Nurse Practitioner
  • Union City, TN
  • NPI 1619977584
  Medicare reassignment Care Compare group NPD Authorized official
• Jennifer Rene Jennings, FNP-BC

  • Family Nurse Practitioner
  • McKenzie, TN
  • NPI 1891249645
  Medicare reassignment Care Compare group NPD
• Amanda Denise Polman, RN, BSN, FNP

  • Family Nurse Practitioner
  • Union City, TN
  • NPI 1801595764
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1205107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772582400000",
    "number": "1053581744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 E REELFOOT AVE STE 100",
            "address_2": "PO BOX 398",
            "city": "UNION CITY",
            "state": "TN",
            "postal_code": "382615886",
            "telephone_number": "731-885-9687",
            "fax_number": "731-885-6643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 EAST REELFOOT AVE",
            "address_2": "SUITE 100",
            "city": "UNION CITY",
            "state": "TN",
            "postal_code": "38261",
            "telephone_number": "731-885-9687",
            "fax_number": "731-885-6643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TERRELL CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-10",
        "last_updated": "2026-03-04",
        "certification_date": "2026-03-04",
        "status": "A",
        "authorized_official_last_name": "NAGEL-TERRELL",
        "authorized_official_first_name": "RENEA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "731-885-9687",
        "authorized_official_credential": "CFNP-DNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "RN92056",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TN",
            "license": "APN6675",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1801595764",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1054900",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP",
            "identifier": "1053581744",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1053581744",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1619977584",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1891249645",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachel J Taylor, OT
• Jessica Garcia Tejeda, PHARMD
• Tennessee Community Services Agency
• Tennessee Community Services Agency
• Tennessee Community Services Agency
• Shelby Terry, OT
• Sandra Jean Tharpe, APN
• The Specialty Clinic, PLLC
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• Family Nurse Practitioner in Union City, TN
• Providers in Union City, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.