Individual provider Active NPI

Terry W Roush, PPCNP-BC

  • Pediatric Nurse Practitioner
  • Chillicothe, OH
National Provider Identifier
1306318662
Registry record updated Apr 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
APRN.CNP.024684 Issued in OH
Practice address
1264 Hospital Rd
Chillicothe, OH 45601
Phone
(740) 779-6805
NPI assigned
Dec 27, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X APRN.CNP.024684 OH Primary

Addresses

Primary practice location

1264 Hospital Rd
Chillicothe, OH 45601

Mailing address

1264 Hospital Rd
Chillicothe, OH 45601-7100
Phone (740) 779-6805

Other practice location 1

2694 Nc 24-87
Cameron, NC 28326-6957
Phone (919) 373-3636

Other practice location 2

5030 N Walnut St
South Bloomfield, OH 43103-1018
Phone (740) 983-0015

Other identifiers 1

IdentifierTypeStateIssuer
0349445MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20200529002214 OH Practitioner - Nurse Practitioner 9931520954 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Community Practices, LLC CurrentSince Mar 1, 2020 Accepting new patients
Phycinity PLLC Past Accepting new patients

Locations

1264 Hospital Rd
Chillicothe, OH 45601
Phone (740) 779-6801

700 Childrens Dr
Columbus, OH 43205
Phone (614) 722-4411

5030 N Walnut St
South Bloomfield, OH 43103
Phone (740) 983-0015

Organizations & group practices 2

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": "1545868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744243200000",
    "number": "1306318662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1264 HOSPITAL RD",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "456017100",
            "telephone_number": "740-779-6805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1264 HOSPITAL RD",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "45601",
            "telephone_number": "740-779-6805"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2694 Nc 24-87",
            "address_purpose": "LOCATION",
            "city": "Cameron",
            "state": "NC",
            "postal_code": "283266957",
            "country_code": "US",
            "telephone_number": "919-373-3636",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5030 N Walnut St",
            "address_purpose": "LOCATION",
            "city": "South Bloomfield",
            "state": "OH",
            "postal_code": "431031018",
            "country_code": "US",
            "telephone_number": "740-983-0015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROUSH",
        "first_name": "TERRY",
        "middle_name": "W",
        "name_prefix": "Mr.",
        "credential": "PPCNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-12-27",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OH",
            "license": "APRN.CNP.024684",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0349445",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chillicothe, OH

Sources for this page

Verify at the official NPI Registry.