Terry H Ezell, M.D.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

17708 Issued in SC

Practice address

1780 Medical Park Dr
Rock Hill, SC 29732-1194

Phone

(803) 327-1116

Fax

(803) 327-6872

NPI assigned

Nov 17, 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 8

Medicare fee-for-service enrollment

Enrolled in SC

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

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.

• Carolina Urology Partners PLLC

  • Urology Physician
  • Huntersville, NC
  • NPI 1013210004

  SC

  Medicare reassignment
• Carolina Urology Center, PA

  • Urology Physician
  • Rock Hill, SC
  • NPI 1366467250
  NPD (past)

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427760000000",
    "number": "1083788673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9735 KINCEY AVE",
            "address_2": "SUITE 201",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280789118",
            "telephone_number": "704-414-2870",
            "fax_number": "704-414-2860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1780 MEDICAL PARK DR",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297321194",
            "telephone_number": "803-327-1116",
            "fax_number": "803-327-6872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EZELL",
        "first_name": "TERRY",
        "middle_name": "H",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-17",
        "last_updated": "2015-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "SC",
            "license": "17708",
            "primary": true
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NC",
            "license": "95-00570",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89136H3",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0005525006",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC",
            "identifier": "136H3",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "57365",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1905786",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "279866",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "177089",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GREAT WEST",
            "identifier": "760694",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Expressed Health Spine and Wellness Center LLC
• Eye & Lens LLC
• Eye Care Plus, LLC
• Eyemart Express LLC
• Eyes on the Road Optometry, PLLC
• Ashton Fabian, M.S. CCC-SLP
• Donna Lynn Faile, LPC
• Reagan E Faile, PHARMD
• Spencer Reid Fair, DMD
• Hannah Fairfax

• Urology Physician in Rock Hill, SC
• Providers in Rock Hill, SC by specialty
• Urology Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2015; 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.