Terry Carson Belisle

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0024172789 Issued in VA

Practice address

20471 Azen Rd
Damascus, VA 24236-4141

Phone

(276) 388-3411

Fax

(276) 388-3732

NPI assigned

Jul 22, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in VA

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

Medicare enrollment (NPD)

Enrolled

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.

• St. Charles Health Council, Inc

  dba Stone Mountain Health Services Pharmacy

  • Pharmacy
  • Ewing, VA
  • NPI 1275594095
  NPD (past)

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

{
    "created_epoch": "1437523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437523200000",
    "number": "1396120192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 608",
            "city": "PENNINGTON GAP",
            "state": "VA",
            "postal_code": "242770608",
            "telephone_number": "276-546-2165",
            "fax_number": "276-546-9701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20471 AZEN RD",
            "city": "DAMASCUS",
            "state": "VA",
            "postal_code": "242364141",
            "telephone_number": "276-388-3411",
            "fax_number": "276-388-3732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELISLE",
        "first_name": "TERRY",
        "middle_name": "CARSON",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-22",
        "last_updated": "2015-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0001222794",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024172789",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF NURSING",
            "identifier": "0024172789",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF NURSING",
            "identifier": "0001222794",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katherine Burner Barnett, LCSW
• Lacy Clay, PHARM.D.
• Damascus Volunteer Rescue Squad, Inc
• David R. Tebbenkamp DDS PC
• Rebecca Hill Dearmond II
• Thomas Raymond Foltz Jr., D.C.

• Family Nurse Practitioner in Damascus, VA
• Providers in Damascus, VA by specialty
• Family Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2015; 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.