Individual provider Active NPI

Jevita Denise Terry, FNP-BC

  • Family Nurse Practitioner
  • Rocky Mount, NC
National Provider Identifier
1508016908
Registry record updated Mar 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
120969 Issued in NC
Practice address
300 N Grace St
Rocky Mount, NC 27804-5345
Phone
(252) 210-9856
Fax
(252) 822-5067
NPI assigned
Sep 23, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 120969 NC Primary

Addresses

Primary practice location

300 N Grace St
Rocky Mount, NC 27804-5345

Mailing address

PO Box 2723
Rocky Mount, NC 27802-2723
Phone (252) 210-9856

Other names 1

  • Jevita Bostic Terry Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20101117001305 NC Practitioner - Nurse Practitioner 2264628155 Reassigns benefits to 1 organization
Practice locations: Zebulon, NC

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of Edgecombe Office of AuditorGroup PAC ID 6204723497, 2 clinicians

Practice addresses (Care Compare)

122 E Saint James St
Tarboro, NC 27886-5016
Phone (252) 641-7511

155 Atlantic Ave
Rocky Mount, NC 27801-5493
Phone (252) 985-4100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
120969NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
County of Edgecombe Office of Auditor CurrentSince Dec 10, 2019 Accepting new patients
County of Edgecombe Office of Auditor CurrentSince Dec 10, 2019 Accepting new patients
Hope Medical Care Past Accepting new patients
Sovran Senior Living, LLC Past Accepting new patients
Loving Hands Wellness & Primary Care PastSince Oct 14, 2019 Accepting new patients

Locations

155 Atlantic Ave
Rocky Mount, NC 27801
Phone (252) 985-4100

122 E Saint James St
Tarboro, NC 27886
Phone (252) 641-7518

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/13314/brand/1/csg/1/fhir/r4

Organizations & group practices 5

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": "1222128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457481600000",
    "number": "1508016908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2723",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278022723",
            "telephone_number": "252-210-9856",
            "fax_number": "252-822-5067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 N GRACE ST",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278045345",
            "telephone_number": "252-210-9856",
            "fax_number": "252-822-5067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERRY",
        "first_name": "JEVITA",
        "middle_name": "DENISE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-23",
        "last_updated": "2016-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "120969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEVITA",
            "last_name": "TERRY",
            "middle_name": "BOSTIC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Rocky Mount, NC

Sources for this page

Verify at the official NPI Registry.