Roger E Terry

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1521PT Issued in MT

Practice address

401 W Pennsylvania St
Anaconda, MT 59711-1931

Phone

(406) 563-8500

Fax

(406) 563-8565

NPI assigned

Sep 10, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: roger.terry.1@15204.direct.athenahealth.com

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.

• Peak Performance Physical Therapy PC

  • Physical Therapy Clinic/Center
  • Missoula, MT
  • NPI 1871581058

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1221004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221004800000",
    "number": "1497904809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 W PENNSYLVANIA ST",
            "city": "ANACONDA",
            "state": "MT",
            "postal_code": "597111931",
            "telephone_number": "406-563-8500",
            "fax_number": "406-563-8565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 W PENNSYLVANIA ST",
            "city": "ANACONDA",
            "state": "MT",
            "postal_code": "597111931",
            "telephone_number": "406-563-8500",
            "fax_number": "406-563-8565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERRY",
        "first_name": "ROGER",
        "middle_name": "E",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-10",
        "last_updated": "2008-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MT",
            "license": "1521PT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "1521PT",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Anaconda, MT
• Providers in Anaconda, MT by specialty
• Physical Therapist in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.