Active NPI
Virginia Ruth Terry, R.D.
- Registered Dietitian
- Roseburg, OR
National Provider Identifier
1104924406
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 811605
- Practice address
- 1813 W Harvard Ave
Ste 427
Roseburg, OR 97471-8712 - Phone
- (541) 784-5966
- NPI assigned
- Sep 20, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 811605 | Primary |
Addresses
Primary practice location
1813 W Harvard Ave
Ste 427
Roseburg, OR 97471-8712
Mailing address
1866 NE Klamath Ave
Roseburg, OR 97470-3554
Phone (541) 784-5966
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Registered Dietitian Or Nutrition Professional
- Education
- Other, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
150 NE Kenneth Ford Dr
Roseburg, OR 97470-1042
Phone (541) 672-9596
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Umpqua Community Health Center, Inc. | Current | Accepting new patients | |
| Umpqua Community Health Center, Inc. | Current | Accepting new patients |
Locations
150 NE Kenneth Ford Dr
Roseburg, OR 97470
Interoperability endpoints
- virginia.terry.1@17792.direct.athenahealth.com
Organizations & group practices 2
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.
-
- Federally Qualified Health Center (FQHC)
- Roseburg, OR
- NPI 1396751772
-
dba Aviva Health
- Federally Qualified Health Center (FQHC)
- Roseburg, OR
- NPI 1720803810
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663286400000",
"number": "1104924406",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1866 NE KLAMATH AVE",
"city": "ROSEBURG",
"state": "OR",
"postal_code": "974703554",
"telephone_number": "541-784-5966"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1813 W HARVARD AVE",
"address_2": "STE 427",
"city": "ROSEBURG",
"state": "OR",
"postal_code": "974718712",
"telephone_number": "541-784-5966"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TERRY",
"first_name": "VIRGINIA",
"middle_name": "RUTH",
"name_prefix": "Ms.",
"credential": "R.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-09-20",
"last_updated": "2022-09-16",
"certification_date": "2022-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": null,
"license": "811605",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Roseburg, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2022; 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.