Terry Brent Ponder, M.D.

Primary specialty

Anatomic Pathology PhysicianTaxonomy code 207ZP0101X

License

36726 Issued in MO

Practice address

5301 Virginia Way
Suite 300
Brentwood, TN 37027-7541

Phone

(615) 695-4977

Fax

(615) 263-3348

NPI assigned

Mar 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Consultants in Laboratory Medicine of Greater Toledo

  • Anatomic Pathology & Clinical Pathology Physician
  • Toledo, OH
  • NPI 1982673372

  MI

  Medicare reassignment
• Associated Pathologists LLC

  • Clinical Medical Laboratory
  • Nashville, TN
  • NPI 1124075635
  NPD (past)
• American Health MW, LLC

  • Clinical Medical Laboratory
  • Cincinnati, OH
  • NPI 1790101681
  NPD (past)
• Lima Memorial Joint Operating Company

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)
• St Louis University

  • Optician
  • Saint Louis, MO
  • NPI 1487869863
  NPD (past)

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

{
    "created_epoch": "1142812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459900800000",
    "number": "1336108349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5301 VIRGINIA WAY",
            "address_2": "SUITE 300",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277541",
            "telephone_number": "615-695-4977",
            "fax_number": "615-263-3348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 VIRGINIA WAY",
            "address_2": "SUITE 300",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277541",
            "telephone_number": "615-695-4977",
            "fax_number": "615-263-3348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONDER",
        "first_name": "TERRY",
        "middle_name": "BRENT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-20",
        "last_updated": "2016-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "OH",
            "license": "35085815",
            "primary": false
        },
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "MI",
            "license": "4301090981",
            "primary": false
        },
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "MO",
            "license": "36726",
            "primary": true
        },
        {
            "code": "207ZC0500X",
            "taxonomy_group": "",
            "desc": "Pathology, Cytopathology",
            "state": "MO",
            "license": "36726",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2549095",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4715743",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tani Theodore Polansky
• Jeremiah Polk, DC
• Michael Pollard
• Abby Pollock, LPC-MHSP
• Morgan Leigh Polston, M.S., CF-SLP
• Pontchartrain Medical Group, a Professional Corporation
• Lauren Ellis Poole, DMD
• Alexis Poplion
• Natalie D Popp, MA, LPC-MHSP (TEMP)
• Kiara Carolina Porro, DNP, APRN, PMHNP-BC

• Anatomic Pathology Physician in Brentwood, TN
• Providers in Brentwood, TN by specialty
• Anatomic Pathology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.