NPIMap

Individual provider Active NPI

Jeffrey A. Terrell, P.T.

  • Physical Therapist
  • Gardendale, AL
National Provider Identifier
1205880119
Registry record updated Feb 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTH3430 Issued in AL
Practice address
2217 Decatur Hwy
Suite 123
Gardendale, AL 35071-2301
Phone
(205) 418-1200
Fax
(205) 418-1210
NPI assigned
May 22, 2006
Last updated
Feb 4, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PTH3430 AL Primary

Addresses

Primary practice location

2217 Decatur Hwy
Suite 123
Gardendale, AL 35071-2301

Mailing address

2217 Decatur Hwy
Suite 123
Gardendale, AL 35071-2301
Phone (205) 418-1200

Other identifiers 3

IdentifierTypeStateIssuer
6400005OtherALUNITED HEALTHCARE
051531652OtherALBLUE CROSS & BLUE SHIELD
051531652MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PTH3430ALMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Complete Family Medicine Past Accepting new patients
Cullman Physical Therapy, LLC Past Accepting new patients
Performance Group Cullman, LLC Physical Therapist Past Accepting new patients
Performance Group Albertville Physical Therapist Past Accepting new patients
Complete Family Practice Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IDFDCD

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265241600000",
    "number": "1205880119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2217 DECATUR HWY",
            "address_2": "SUITE 123",
            "city": "GARDENDALE",
            "state": "AL",
            "postal_code": "350712301",
            "telephone_number": "205-418-1200",
            "fax_number": "205-418-1210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2217 DECATUR HWY",
            "address_2": "SUITE 123",
            "city": "GARDENDALE",
            "state": "AL",
            "postal_code": "350712301",
            "telephone_number": "205-418-1200",
            "fax_number": "205-418-1210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERRELL",
        "first_name": "JEFFREY",
        "middle_name": "A.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-22",
        "last_updated": "2010-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "PTH3430",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "6400005",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS & BLUE SHIELD",
            "identifier": "051531652",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051531652",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gardendale, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.