Individual provider Active NPI

Vania Terry

  • Primary Care Nurse Practitioner
  • Danvers, MA
National Provider Identifier
1124594650
Registry record updated Mar 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
RN2282448 Issued in MA
Practice address
17 Loris Rd
Danvers, MA 01923-1802
Phone
(781) 856-5083
Fax
(781) 856-5083
NPI assigned
Oct 23, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X RN2282448 MA Primary

Addresses

Primary practice location

17 Loris Rd
Danvers, MA 01923-1802

Mailing address

17 Loris Rd
Danvers, MA 01923-1802

Other names 1

  • Vania Ibacache Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20190116002849 MA Practitioner - Nurse Practitioner 7113263849 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN2282448MAMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lynn Community Health, Inc. CurrentSince Jan 7, 2019 Accepting new patients
Healthdrive Behavioral Health Services, PLLC CurrentSince Oct 1, 2021 Accepting new patients

Locations

100 Crossing Blvd
Ste 300
Framingham, MA 01702
Phone (857) 255-0486

280 Union St
Ste 202
Lynn, MA 01901
Phone (781) 780-4555

269 Union St
Lynn, MA 01901
Phone (781) 581-9832

103 Myron St
Ste A
West Springfield, MA 01089
Phone (978) 388-1010

Interoperability endpoints

  • Direct secure messaging: vania.terry.p1@direct.elementcare.nextgenshare.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.

NPI Registry JSON

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

{
    "created_epoch": "1540252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741824000000",
    "number": "1124594650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 LORIS RD",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019231802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 LORIS RD",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019231802",
            "telephone_number": "781-856-5083",
            "fax_number": "781-856-5083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERRY",
        "first_name": "VANIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-23",
        "last_updated": "2025-03-13",
        "certification_date": "2025-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MA",
            "license": "RN2282448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VANIA",
            "last_name": "IBACACHE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Danvers, MA

Sources for this page

Verify at the official NPI Registry.