Active NPI
Terrill Henry Lott
- Phlebology Physician
- Cedar Grove, NJ
National Provider Identifier
1295483469
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Phlebology Physician
- License
- 0450770928
- Practice address
- 91-93 Rte. 23 Pompton Ave.
Suite 1001
Cedar Grove, NJ 07009 - Phone
- (201) 815-0605
- NPI assigned
- Mar 16, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Phlebology Physician | 202K00000X | 0450770928 | NJ | Primary |
Addresses
Primary practice location
91-93 Rte. 23 Pompton Ave.
Suite 1001
Cedar Grove, NJ 07009
Mailing address
91-93 Rte. 23 Pompton Ave.
Suite 1001
Cedar Grove, NJ 07009
Phone (201) 815-0605
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0450770928 | NJ | MD | Phlebology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1647388800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647388800000",
"number": "1295483469",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "91-93 RTE. 23 POMPTON AVE.",
"address_2": "SUITE 1001",
"city": "CEDAR GROVE",
"state": "NJ",
"postal_code": "07009",
"telephone_number": "201-815-0605"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "91-93 RTE. 23 POMPTON AVE.",
"address_2": "SUITE 1001",
"city": "CEDAR GROVE",
"state": "NJ",
"postal_code": "07009",
"telephone_number": "201-815-0605"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOTT",
"first_name": "TERRILL",
"middle_name": "HENRY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-03-16",
"last_updated": "2022-03-16",
"certification_date": "2022-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "202K00000X",
"taxonomy_group": "",
"desc": "Phlebology",
"state": "NJ",
"license": "0450770928",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cedar Grove, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.