Individual provider Active NPI

Patricia A Terry, NP

  • Nurse Practitioner
  • Carson City, MI
National Provider Identifier
1104892140
Registry record updated Nov 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704169723 Issued in MI
Practice address
102 S Third St
Suite 100
Carson City, MI 48811
Phone
(989) 584-1308
Fax
(989) 584-0307
NPI assigned
Feb 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704169723 MI Primary

Addresses

Primary practice location

102 S Third St
Suite 100
Carson City, MI 48811

Mailing address

PO Box 730
406 E Elm St
Carson City, MI 48811
Phone (989) 584-3131

Other identifiers 2

IdentifierTypeStateIssuer
P00700259OtherMIRAILROAD MEDICARE
4385156MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060605000055 MI Practitioner - Nurse Practitioner 2466463575 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704169723MIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sparrow Carson Hospital CurrentSince Sep 28, 2010 Accepting new patients
Sparrow Carson Hospital CurrentSince Sep 28, 2010 Accepting new patients
Sparrow Carson Hospital Current Accepting new patients

Locations

8175 Reliable Pkwy
Chicago, IL 60686

102 S 3rd St
Ste 100
Carson City, MI 48811
Phone (989) 584-1308

406 E Elm St
Carson City, MI 48811
Phone (517) 584-3131

1014 E Washington St
Greenville, MI 48838
Phone (616) 754-7145

Interoperability endpoints

  • Direct secure messaging: pterry53323@sparrowdirecthie.org
  • Direct secure messaging: pterry@yourcarecommunity.org

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": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258934400000",
    "number": "1104892140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 730",
            "address_2": "406 E ELM ST",
            "city": "CARSON CITY",
            "state": "MI",
            "postal_code": "48811",
            "telephone_number": "989-584-3131",
            "fax_number": "989-584-6734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 S THIRD ST",
            "address_2": "SUITE 100",
            "city": "CARSON CITY",
            "state": "MI",
            "postal_code": "48811",
            "telephone_number": "989-584-1308",
            "fax_number": "989-584-0307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERRY",
        "first_name": "PATRICIA",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-28",
        "last_updated": "2009-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704169723",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00700259",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4385156",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carson City, MI

Sources for this page

Verify at the official NPI Registry.