Individual provider Active NPI

Zachary William Terry, PA

  • Physician Assistant
  • Salt Lake City, UT
National Provider Identifier
1255356275
Registry record updated Mar 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3687691206 Issued in UT
Practice address
370 9TH Ave
Ste 205
Salt Lake City, UT 84103-2877
Phone
(801) 408-8700
Fax
(801) 408-8732
NPI assigned
Jul 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 3687691206 UT Primary

Addresses

Primary practice location

370 9TH Ave
Ste 205
Salt Lake City, UT 84103-2877

Mailing address

5848 S Fashion Blvd
Ste 110
Salt Lake City, UT 84107-6175
Phone (801) 314-4130

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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
I20051005001176 UT Practitioner - Physician Assistant 3678598976 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Orthopedic Clinic LCGroup PAC ID 8527090729, 18 clinicians

Practice addresses (Care Compare)

11762 S State St
Suite 160
Draper, UT 84020-7174
Phone (801) 314-4195

5848 S Fashion Blvd
Suite 110
Salt Lake City, UT 84107-6175
Phone (801) 314-4188

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
3687691206UTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Sep 12, 2005 Accepting new patients
Ihc Health Services Inc CurrentSince Apr 28, 2019 Accepting new patients
Ihc Health Services Inc CurrentSince Sep 12, 2005 Accepting new patients

Locations

425 Medical Dr
#220
Bountiful, UT 84010
Phone (801) 292-7288

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

400 C St
Salt Lake Cty, UT 84143
Phone (435) 688-4080

5848 S Fashion Blvd
Ste 110
Salt Lake Cty, UT 84107
Phone (801) 314-4188

370 Ninth Ave
Ste 205
Salt Lake Cty, UT 84103
Phone (801) 355-9951

Interoperability endpoints

  • Direct secure messaging: zachary.terry.1@28271.direct.athenahealth.com

Organizations & group practices 6

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490832000000",
    "number": "1255356275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5848 S FASHION BLVD",
            "address_2": "STE 110",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841076175",
            "telephone_number": "801-314-4130",
            "fax_number": "801-314-4015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "370 9TH AVE",
            "address_2": "STE 205",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841032877",
            "telephone_number": "801-408-8700",
            "fax_number": "801-408-8732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERRY",
        "first_name": "ZACHARY",
        "middle_name": "WILLIAM",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2017-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "3687691206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.