Individual provider Active NPI

Jill M. Terrien, NP

  • Adult Health Nurse Practitioner
  • Worcester, MA
National Provider Identifier
1104105865
Registry record updated Aug 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
159440 Issued in MA
Practice address
486 Chandler St
Room G-209
Worcester, MA 01602-2861
Phone
(508) 929-8875
NPI assigned
Aug 12, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 159440 MA Primary
Adult Health Nurse Practitioner 363LA2200X 003055 CT

Addresses

Primary practice location

486 Chandler St
Room G-209
Worcester, MA 01602-2861

Mailing address

486 Chandler St
Room G-209
Worcester, MA 01602-2861
Phone (508) 929-8875

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
003055CTMDClinical Social Worker
159440MAMDAdult Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1313107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313107200000",
    "number": "1104105865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "486 CHANDLER ST",
            "address_2": "ROOM G-209",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016022861",
            "telephone_number": "508-929-8875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "486 CHANDLER ST",
            "address_2": "ROOM G-209",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016022861",
            "telephone_number": "508-929-8875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERRIEN",
        "first_name": "JILL",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-12",
        "last_updated": "2011-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MA",
            "license": "159440",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CT",
            "license": "003055",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.