Individual provider Active NPI

Terra J. Davis, PA-C

  • Physician Assistant
  • Dallas, TX
National Provider Identifier
1265491393
Registry record updated Jul 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA03943 Issued in TX
Practice address
5323 Harry Hines Blvd
Dallas, TX 75390-7201
Phone
(214) 645-2800
Fax
(214) 645-0078
NPI assigned
Mar 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2016

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 PA03943 TX Primary

Addresses

Primary practice location

5323 Harry Hines Blvd
Dallas, TX 75390-7201

Mailing address

PO Box 845347
Dallas, TX 75284-5347
Phone (214) 645-2800

Other names 1

  • Terra J. Nichols Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20040723000869 TX Practitioner - Physician Assistant 9537149075 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2201 Inwood Rd
Dallas, TX 75235-7320
Phone (214) 645-2700

3621 22ND St
Suite 400
Lubbock, TX 79410-1302
Phone (806) 791-8484

5939 Harry Hines Blvd
Dallas, TX 75235-6246

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA03943TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Jul 30, 2017 Accepting new patients
Dallas Nephrology Associates CurrentSince Apr 28, 2011 Accepting new patients
University of Texas Southwestern Medical Center at Dallas CurrentSince Jul 30, 2017 Accepting new patients
Medical Clinic of North Texas PLLC Past Accepting new patients
Dallas Nephrology Associates Past Accepting new patients

Locations

2201 Inwood Rd
Dallas, TX 75235
Phone (214) 645-2563

1150 N Bishop Ave
Ste 100
Dallas, TX 75208
Phone (214) 956-8200

3621 22nd St
Ste 400
Lubbock, TX 79410
Phone (806) 791-8484

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • FHIR API: https://epicproxy.et1041.epichosted.com/FHIRProxy/api/FHIR/R4/

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1142640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467936000000",
    "number": "1265491393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 845347",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752845347",
            "telephone_number": "214-645-2800",
            "fax_number": "214-645-0078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5323 HARRY HINES BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753907201",
            "telephone_number": "214-645-2800",
            "fax_number": "214-645-0078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "TERRA",
        "middle_name": "J.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-18",
        "last_updated": "2016-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA03943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TERRA",
            "last_name": "NICHOLS",
            "middle_name": "J.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.