NPIMap

Individual provider Active NPI

Terry A Treadwell, MD

  • Surgery Physician
  • Montgomery, AL
National Provider Identifier
1376637025
Registry record updated Jan 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
11176 Issued in AL
Practice address
2167 Normandie Dr
Montgomery, AL 36111-2728
Phone
(334) 747-3444
Fax
(334) 747-3450
NPI assigned
Oct 3, 2006
Last updated
Jan 6, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 11176 AL Primary

Addresses

Primary practice location

2167 Normandie Dr
Montgomery, AL 36111-2728

Mailing address

301 Brown Springs Rd
Montgomery, AL 36117-7005
Phone (334) 747-4159

Other identifiers 6

IdentifierTypeStateIssuer
051531984 529929310MedicaidAL
1710077OtherALUNITED HEALTH CARE
C71058OtherALVIVA
203204949OtherALFED TAX ID
203204949OtherALHEALTH CHOICE
C71058 31984OtherALBLUE CROSS SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050926000371 AL Practitioner - Family Practice 4284668518 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
11176ALMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Health Care Authority for Baptist Health, an Affiliate of Uabhs CurrentSince Feb 1, 2006 Accepting new patients
The Health Care Authority for Baptist Health CurrentSince Feb 1, 2006 Accepting new patients
Health Care Authority for Baptist Health, an Affiliate of Uabhs Current Accepting new patients
Health Care Authority for Baptist Health an Affiliate of Uabhs Past Accepting new patients
Health Care Authority for Baptist Health, an Affiliate of Uabhs Past Accepting new patients
Health Care Authority for Baptist Health, an Affiliate of Uabhs Past Accepting new patients
The Health Care Authority for Baptist Health Past Accepting new patients
The Health Care Authority for Baptist Health an Affiliate of Uabhs Past Accepting new patients
Health Care Authority for Baptist Health, an Affiliate of Uabhs Past Accepting new patients
The Health Care Authority for Baptist Health Past Accepting new patients

Locations

2167 Normandie Dr
Montgomery, AL 36111
Phone (334) 286-3444

301 Brown Springs Rd
Montgomery, AL 36117
Phone (334) 273-4159

Interoperability endpoints

  • Direct secure messaging: terry.treadwell@direct.baptistfirst.org

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672963200000",
    "number": "1376637025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 BROWN SPRINGS RD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361177005",
            "telephone_number": "334-747-4159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2167 NORMANDIE DR",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361112728",
            "telephone_number": "334-747-3444",
            "fax_number": "334-747-3450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TREADWELL",
        "first_name": "TERRY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2023-01-06",
        "certification_date": "2023-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AL",
            "license": "11176",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051531984 529929310",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "1710077",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIVA",
            "identifier": "C71058",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FED TAX ID",
            "identifier": "203204949",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH CHOICE",
            "identifier": "203204949",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS SHIELD",
            "identifier": "C71058 31984",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

Verify at the official NPI Registry.