Individual provider Active NPI

Terrie Ashlyn Petty, FNP

  • Family Nurse Practitioner
  • Paris, TX
National Provider Identifier
1124668934
Registry record updated Feb 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP144858 Issued in TX
Practice address
1800 Farm Road 195
Paris, TX 75462-2806
Phone
(903) 739-7920
NPI assigned
Jan 9, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 813498 TX
Nurse Practitioner 363L00000X AP144858 TX
Family Nurse Practitioner 363LF0000X AP144858 TX Primary

Addresses

Primary practice location

1800 Farm Road 195
Paris, TX 75462-2806

Mailing address

1800 Farm Road 195
Paris, TX 75462-2806
Phone (903) 739-7920

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20200219001419 TX Practitioner - Nurse Practitioner 6406283159 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Tapia Internal Medicine Clinic PLLCGroup PAC ID 5799909040, 7 clinicians

Practice addresses (Care Compare)

1800 Farm Rd
Suite 195
Paris, TX 75462-2806
Phone (903) 739-7920

Hospital & facility affiliations

  • Golden Care Home Health, LLC Home health agency, Paris, TX, CCN 748044
  • Paris Regional Medical Center Hospital, Paris, TX, CCN 450196

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
813498TXMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Tapia Internal Medicine Clinic PLLC CurrentSince Jan 29, 2020 Accepting new patients

Locations

501 N Locust St
Clarksville, TX 75426
Phone (903) 427-3460

1800 Farm Road 195
Paris, TX 75462
Phone (903) 739-7920

Interoperability endpoints

  • Direct secure messaging: ashlyn.petty.1@8762.direct.athenahealth.com

Organizations & group practices 1

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1578528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707782400000",
    "number": "1124668934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 FARM ROAD 195",
            "city": "PARIS",
            "state": "TX",
            "postal_code": "754622806",
            "telephone_number": "903-739-7920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 FARM ROAD 195",
            "city": "PARIS",
            "state": "TX",
            "postal_code": "754622806",
            "telephone_number": "903-739-7920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTY",
        "first_name": "TERRIE",
        "middle_name": "ASHLYN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-09",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "813498",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP144858",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP144858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paris, TX

Sources for this page

Verify at the official NPI Registry.