Individual provider Active NPI

Latera D Terry

  • Physician Assistant
  • Lawrenceville, GA
National Provider Identifier
1407193014
Registry record updated Jul 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
8448 Issued in GA
Practice address
5710 Sugarloaf Pkwy
Lawrenceville, GA 30043-7834
Phone
(770) 237-2222
NPI assigned
Jan 16, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 8448 GA Primary

Addresses

Primary practice location

5710 Sugarloaf Pkwy
Lawrenceville, GA 30043-7834

Mailing address

5710 Sugarloaf Pkwy
Lawrenceville, GA 30043-7834
Phone (770) 237-2222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20180108002345 GA Practitioner - Physician Assistant 6204195795 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Primary Care PLLCGroup PAC ID 0941642169, 19 clinicians
Minuteclinic LLCGroup PAC ID 6709850241, 576 clinicians

Practice addresses (Care Compare)

11710 Alpharetta Hwy
Roswell, GA 30076-3807
Phone (866) 389-2727

2720 Loganville Hwy
Loganville, GA 30052-7715
Phone (866) 389-2727

5370 Laurel Springs Pkwy
Suwanee, GA 30024-6027
Phone (866) 389-2727

5710 Sugarloaf Pkwy
Lawrenceville, GA 30043-7834
Phone (866) 389-2727

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
8448GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic LLC Physician Assistant CurrentSince Jul 7, 2025 Accepting new patients
Privia Medical Group of Georgia LLC Internal Medicine CurrentSince Aug 20, 2019 Accepting new patients
Physician First Health Network PastSince Jun 3, 2025 Accepting new patients

Locations

101 Yorktown Dr
Ste 100
Fayetteville, GA 30214
Phone (770) 460-4285

5710 Sugarloaf Pkwy
Lawrenceville, GA 30043
Phone (770) 237-2222

11710 Alpharetta Hwy
Roswell, GA 30076
Phone (770) 754-0141

7207 Rockbridge Rd
Stone Mtn, GA 30087
Phone (770) 469-2002

1 Cvs Dr
#2295
Woonsocket, RI 02895
Phone (401) 770-8043

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678

Organizations & group practices 9

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": "1358294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751328000000",
    "number": "1407193014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5710 SUGARLOAF PKWY",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300437834",
            "telephone_number": "770-237-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5710 SUGARLOAF PKWY",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300437834",
            "telephone_number": "770-237-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERRY",
        "first_name": "LATERA",
        "middle_name": "D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-16",
        "last_updated": "2025-07-01",
        "certification_date": "2025-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "8448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

Verify at the official NPI Registry.