Individual provider Active NPI

Karen Jean Terrell, NP-C

  • Family Nurse Practitioner
  • Brunswick, GA
National Provider Identifier
1245675198
Registry record updated Sep 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN171345 NP Issued in GA
Practice address
11 Judicial LN Ste 204
Brunswick, GA 31520-6950
Phone
(912) 279-3800
Fax
(912) 279-3806
NPI assigned
May 6, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN171345 NP GA Primary

Addresses

Primary practice location

11 Judicial LN Ste 204
Brunswick, GA 31520-6950

Mailing address

11 Judicial LN Ste 204
Brunswick, GA 31520-6950
Phone (912) 279-3800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20130723000971 GA Practitioner - Nurse Practitioner 6608016209 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

Practice roles

OrganizationSpecialtyStatusNew patients
Cooperative Healthcare Services Inc CurrentSince Jun 9, 2013 Accepting new patients

Locations

3222 Shrine Rd
#A
Brunswick, GA 31520
Phone (912) 264-6303

2415 Parkwood Dr
Brunswick, GA 31520
Phone (912) 466-4079

3222 Shrine Rd
Ste A
Brunswick, GA 31520
Phone (912) 264-6303

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.

NPI Registry JSON

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

{
    "created_epoch": "1367798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1245675198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 JUDICIAL LN STE 204",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315206950",
            "telephone_number": "912-279-3800",
            "fax_number": "912-279-3806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 JUDICIAL LN STE 204",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315206950",
            "telephone_number": "912-279-3800",
            "fax_number": "912-279-3806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERRELL",
        "first_name": "KAREN",
        "middle_name": "JEAN",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-06",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN171345 NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, GA

Sources for this page

Verify at the official NPI Registry.