Max L Terry, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

31475 Issued in AZ

Practice address

2110 Airway Ave
Kingman, AZ 86409-3652

Phone

(928) 681-1800

Fax

(928) 681-1832

NPI assigned

Jun 8, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Merit-based Incentive Payment System (MIPS)

Final score

53.98 of 100Reported as group

Quality

11.8

Promoting interoperability

74

Improvement activities

0

Cost

82.7

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Grand Canyon Medical Imaging LLC

  • Specialist
  • Kingman, AZ
  • NPI 1629109095
  NPD (past)

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206662400000",
    "number": "1295775815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2110 AIRWAY AVE",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864093652",
            "telephone_number": "928-681-1800",
            "fax_number": "928-681-1832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2110 AIRWAY AVE",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864093652",
            "telephone_number": "928-681-1800",
            "fax_number": "928-681-1832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERRY",
        "first_name": "MAX",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2008-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AZ",
            "license": "31475",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "842501",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD ARIZONA",
            "identifier": "AZ0749420",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Taylor, SLPA
• TDNC LLC
• Joseph Henry Tedesco, D.O.
• Terros Inc
• Terros Inc
• The Lingenfelter Center
• The Lingenfelter Center, LTD
• Joan Thelander-Dalcerro, SPEECHLANGUAGE PATH
• Danita L Thomas
• James Robert Thomas, PH.D., M.D.

• Diagnostic Radiology Physician in Kingman, AZ
• Providers in Kingman, AZ by specialty
• Diagnostic Radiology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.