Individual provider Active NPI

Terry Kent Isbill, O.D.

  • Optometrist
  • Sacramento, CA
National Provider Identifier
1255339073
Registry record updated Jun 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5085T Issued in CA
Practice address
811 Grand Ave
Ste B
Sacramento, CA 95838-3466
Phone
(916) 927-3773
Fax
(916) 927-8304
NPI assigned
Jul 14, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5085T CA Primary

Addresses

Primary practice location

811 Grand Ave
Ste B
Sacramento, CA 95838-3466

Mailing address

811 Grand Ave
Ste B
Sacramento, CA 95838-3466
Phone (916) 927-3773

Other identifiers 1

IdentifierTypeStateIssuer
SD0050850MedicaidCA

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)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
5085TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Paula Vang OD Inc Optometrist PastSince Jan 14, 2018 Accepting new patients

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": "1121299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245110400000",
    "number": "1255339073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 GRAND AVE",
            "address_2": "STE B",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958383466",
            "telephone_number": "916-927-3773",
            "fax_number": "916-927-8304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 GRAND AVE",
            "address_2": "STE B",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958383466",
            "telephone_number": "916-927-3773",
            "fax_number": "916-927-8304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISBILL",
        "first_name": "TERRY",
        "middle_name": "KENT",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-14",
        "last_updated": "2009-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "5085T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0050850",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2009; 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.