Individual provider Active NPI

Terry Allen, NP

  • Nurse Practitioner
  • Livonia, MI
National Provider Identifier
1205397205
Registry record updated Jul 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704264054 Issued in MI
Practice address
14555 Levan Rd
Ste 311
Livonia, MI 48154
Phone
(734) 655-2692
Fax
(734) 655-4218
NPI assigned
Mar 31, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2025

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 4704264054 MI Primary

Addresses

Primary practice location

14555 Levan Rd
Ste 311
Livonia, MI 48154

Mailing address

24 Frank Lloyd Wright Drive
Suite J2000
Ann Arbor, MI 48105
Phone (734) 747-6766

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
I20250623001333 MI Practitioner - Nurse Practitioner 4981116381 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
Group practices
Iha Olma Specialty 1 LLCGroup PAC ID 6901206689, 67 clinicians

Practice addresses (Care Compare)

19000 St Joes Pkwy
Livonia, MI 48152-1477

36475 5 Mile Rd
Livonia, MI 48154-1971
Phone (734) 655-2692

Hospital & facility affiliations

  • St Joe Mercy Hospital System Livonia Hospital, Livonia, MI, CCN 230002

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Iha Olma Specialty 1 LLC Current Accepting new patients
Iha Olma Specialty 1 LLC CurrentSince Aug 1, 2025 Accepting new patients
Iha Olma Specialty 1 LLC CurrentSince Aug 1, 2025 Accepting new patients

Locations

24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105
Phone (734) 930-7400

14555 Levan Rd
Ste 311
Livonia, MI 48154
Phone (248) 858-3850

19000 St Joes Pkwy
Livonia, MI 48152
Phone (734) 655-8250

Interoperability endpoints

  • Direct secure messaging: tallen29158@direct.trinity-health.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.

Hospital & facility affiliations 1

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": "1553990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752796800000",
    "number": "1205397205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 FRANK LLOYD WRIGHT DRIVE",
            "address_2": "SUITE J2000",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "48105",
            "telephone_number": "734-747-6766",
            "fax_number": "734-222-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14555 LEVAN RD",
            "address_2": "STE 311",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "48154",
            "telephone_number": "734-655-2692",
            "fax_number": "734-655-4218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "TERRY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-31",
        "last_updated": "2025-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704264054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

Verify at the official NPI Registry.