Individual provider Active NPI

Terry Dean Neville, M.D.

  • Psychiatry Physician
  • Fort George G Meade, MD
National Provider Identifier
1457336083
Registry record updated May 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
4901 Issued in SD
Practice address
2480 Llewellyn Ave Ste 5800
Fort George G Meade, MD 20755-5129
Phone
(301) 677-8895
NPI assigned
Dec 6, 2005
Last updated
May 14, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 4901 SD Primary

Addresses

Primary practice location

2480 Llewellyn Ave Ste 5800
Fort George G Meade, MD 20755-5129

Mailing address

9475 Lottsford Rd
Ste 250
Largo, MD 20774-5346
Phone (301) 636-6504

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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

Enrollment IDStateProvider typePAC IDDetails
I20181212001345 DC Practitioner - Psychiatry 1355685728 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Sanford School of Medicine of University of South Dakota, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Qci Behavioral Health Consulting Group, LLCGroup PAC ID 3971665969, 18 clinicians

Practice addresses (Care Compare)

9475 Lottsford Rd
Suite 250
Largo, MD 20774-5346
Phone (301) 636-6504

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4901SDMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Qci Behavioral Health Consulting Group, LLC CurrentSince Oct 21, 2018 Accepting new patients

Locations

9475 Lottsford Rd
Ste 250
Upper Marlboro, MD 20774
Phone (301) 636-6504

Organizations & group practices 1

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": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620950400000",
    "number": "1457336083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9475 LOTTSFORD RD",
            "address_2": "STE 250",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207745346",
            "telephone_number": "301-636-6504",
            "fax_number": "301-636-6509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2480 LLEWELLYN AVE STE 5800",
            "city": "FORT GEORGE G MEADE",
            "state": "MD",
            "postal_code": "207555129",
            "telephone_number": "301-677-8895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEVILLE",
        "first_name": "TERRY",
        "middle_name": "DEAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-06",
        "last_updated": "2021-05-14",
        "certification_date": "2021-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "SD",
            "license": "4901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort George G Meade, MD

Sources for this page

Verify at the official NPI Registry.