Individual provider Active NPI

Terry Ellis Cargile, APRN

  • Nurse Practitioner
  • Port Charlotte, FL
National Provider Identifier
1225323181
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN9359842 Issued in FL
Practice address
21297 Olean Blvd
Port Charlotte, FL 33952
Phone
(417) 689-0150
Fax
(941) 249-4609
NPI assigned
Jun 17, 2011
Last updated
Jan 16, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN9359842 FL Primary
Nurse Practitioner 363L00000X 2020014037 MO

Addresses

Primary practice location

21297 Olean Blvd
Port Charlotte, FL 33952

Mailing address

21297 Olean Blvd
Port Charlotte, FL 33952
Phone (417) 689-0150

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180316001494 FL Practitioner - Nurse Practitioner 8628330347 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN9359842FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Spinal Health and Rehab of Punta Gorda CurrentSince Jan 2, 2018 Accepting new patients
Elk River Health Services, Inc. Past Accepting new patients
Elk River Health Services, Inc. Past Accepting new patients
Economic Security Corporation of Southwest Area Past Accepting new patients

Locations

2905 Tamiami Trl
Punta Gorda, FL 33950
Phone (941) 205-2180

324 Cross St
Punta Gorda, FL 33950
Phone (941) 205-2180

Organizations & group practices 4

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": "1308268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736985600000",
    "number": "1225323181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21297 OLEAN BLVD",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "33952",
            "telephone_number": "417-689-0150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21297 OLEAN BLVD",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "33952",
            "telephone_number": "417-689-0150",
            "fax_number": "941-249-4609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARGILE",
        "first_name": "TERRY",
        "middle_name": "ELLIS",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-17",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN9359842",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2020014037",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

Verify at the official NPI Registry.