Individual provider Active NPI

Nancy M Terry, AUDIOLOGY

  • Audiologist
  • Wichita, KS
National Provider Identifier
1083755573
Registry record updated Apr 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
631 Issued in KS
Practice address
1947 N Founders Cir
Wichita, KS 67206-3548
Phone
(316) 613-4695
Fax
(316) 613-4940
NPI assigned
Feb 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 631 KS Primary

Addresses

Primary practice location

1947 N Founders Cir
Wichita, KS 67206-3548

Mailing address

1947 N Founders Cir
Wichita, KS 67206-3548
Phone (316) 613-4695

Other identifiers 1

IdentifierTypeStateIssuer
3387201401MedicaidKS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081003000364 KS Practitioner - Qualified Audiologist 5991873986 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1947 N Founders Cir
Via Christi Clinic PA
Wichita, KS 67206-3548
Phone (316) 613-4640

3311 E Murdock St
Wichita, KS 67208-3054
Phone (316) 689-9349

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
631KSMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Medical Group Via Christi, PA CurrentSince Sep 1, 2008 Accepting new patients
Ascension Medical Group Via Christi, PA CurrentSince Sep 1, 2008 Accepting new patients
Ascension Medical Group Via Christi, PA Past Accepting new patients

Locations

3311 E Murdock St
Wichita, KS 67208
Phone (316) 689-9107

1947 N Founders Cir
Wichita, KS 67206
Phone (316) 613-4640

Organizations & group practices 3

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": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588118400000",
    "number": "1083755573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1947 N FOUNDERS CIR",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672063548",
            "telephone_number": "316-613-4695",
            "fax_number": "316-613-4940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1947 N FOUNDERS CIR",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672063548",
            "telephone_number": "316-613-4695",
            "fax_number": "316-613-4940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERRY",
        "first_name": "NANCY",
        "middle_name": "M",
        "credential": "AUDIOLOGY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-09",
        "last_updated": "2020-04-29",
        "certification_date": "2020-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "KS",
            "license": "631",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3387201401",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 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.