Individual provider Active NPI

Terilyn Marie Darley, APRN

  • Family Nurse Practitioner
  • Iron Mountain, MI
National Provider Identifier
1255049870
Registry record updated Dec 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704305647 Issued in MI
Practice address
440 Woodward Ave Ste 101
Iron Mountain, MI 49801-4631
Phone
(906) 776-9040
NPI assigned
Nov 11, 2022
Last updated
Dec 29, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2022

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 4704305647 MI Primary

Addresses

Primary practice location

440 Woodward Ave Ste 101
Iron Mountain, MI 49801-4631

Mailing address

PO Box 22487
Green Bay, WI 54305-2487
Phone (920) 445-7210

Other identifiers 1

IdentifierTypeStateIssuer
F04220455OtherAMERICAN ACADEMY OF NURSE PRACTITIONERS

Other names 1

  • Terilyn M Poitra Former name

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
I20221230001621 MI Practitioner - Nurse Practitioner 3971973231 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bellin Memorial Hospital IncGroup PAC ID 8820900749, 685 clinicians

Practice addresses (Care Compare)

440 Woodward Ave
Iron Mountain, MI 49801-4631
Phone (906) 776-9040

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bellin Memorial Hospital Inc CurrentSince Dec 29, 2022 Accepting new patients
Bellin Memorial Hospital Inc Current Accepting new patients
Osf Multi-Specialty Group CurrentSince Jul 15, 2023 Accepting new patients
Bellin Memorial Hospital Inc Past Accepting new patients

Locations

440 Woodward Ave
Iron Mountain, MI 49801
Phone (906) 776-9040

440 Woodward Ave
Ste 101
Iron Mountain, MI 49801
Phone (906) 776-9040

Interoperability endpoints

  • Direct secure messaging: tdarley327717@direct.thedacare.org
  • Direct secure messaging: tdarley926070@direct.emplifyhealth.org

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": "1668124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672272000000",
    "number": "1255049870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22487",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543052487",
            "telephone_number": "920-445-7210",
            "fax_number": "920-445-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 WOODWARD AVE STE 101",
            "city": "IRON MOUNTAIN",
            "state": "MI",
            "postal_code": "498014631",
            "telephone_number": "906-776-9040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DARLEY",
        "first_name": "TERILYN",
        "middle_name": "MARIE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-11",
        "last_updated": "2022-12-29",
        "certification_date": "2022-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704305647",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN ACADEMY OF NURSE PRACTITIONERS",
            "identifier": "F04220455",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TERILYN",
            "last_name": "POITRA",
            "middle_name": "M",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Iron Mountain, MI

Sources for this page

Verify at the official NPI Registry.