Thomas Terrell, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

038858 Issued in TN

Practice address

110 Executive Park Dr
Clinton, TN 37716

Phone

(865) 494-9241

Fax

(865) 494-0895

NPI assigned

Oct 11, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 7

Other names 1

• Dr. Thomas Roland Terrell Other name

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• University of Tennessee

  • Multi-Specialty Clinic/Center
  • Knoxville, TN
  • NPI 1295751386
  Medicare reassignment NPD
• University of Tennessee

  • Family Nurse Practitioner
  • Memphis, TN
  • NPI 1174221337
  NPD
• University of Tennessee

  • Multi-Specialty Clinic/Center
  • Knoxville, TN
  • NPI 1689631137
  NPD
• Crossville Medical Group PA

  • Multi-Specialty Clinic/Center
  • Crossville, TN
  • NPI 1053414698
  NPD (past)
• Family Medicine Centers of South Carolina

  • Primary Care Clinic/Center
  • Columbia, SC
  • NPI 1649350273
  NPD (past)
• University Specialty Clinics - Orthopaedics

  • Orthopaedic Surgery Physician
  • Columbia, SC
  • NPI 1215969688
  NPD (past)

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527811200000",
    "number": "1083703003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 EXECUTIVE PARK DR",
            "city": "CLINTON",
            "state": "TN",
            "postal_code": "377166876",
            "telephone_number": "865-494-9241",
            "fax_number": "865-494-0895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 EXECUTIVE PARK DR",
            "city": "CLINTON",
            "state": "TN",
            "postal_code": "37716",
            "telephone_number": "865-494-9241",
            "fax_number": "865-494-0895"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2347 Jones Bend Rd",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "TN",
            "postal_code": "377775213",
            "country_code": "US",
            "telephone_number": "865-970-9800",
            "fax_number": "865-373-8225",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TERRELL",
        "first_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2018-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "TN",
            "license": "038858",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "038858",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID PTAN UFP",
            "identifier": "1522707",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE UFP",
            "identifier": "P00923551",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1522707",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GRP UFP",
            "identifier": "3373352",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN UFP",
            "identifier": "103I083671",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000352900",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS TN UFP",
            "identifier": "4278768",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THOMAS",
            "last_name": "TERRELL",
            "middle_name": "ROLAND",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Tonia R Suttles
• Cheri P Sweet, NP
• Susan Price Teffeteller, FNP-BC
• Tennessee CVS Pharmacy, L.L.C.
• Helen Tenney
• Melody Camille Tharp, MD
• Therapeutic Associates LLC
• Carrie Michelle Thomas, R.N.
• Tracy Thomas
• Joseph L Thompson III, M.D.

• Family Medicine Physician in Clinton, TN
• Providers in Clinton, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.