Individual provider Active NPI

Shadina Terry, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Cleveland, OH
National Provider Identifier
1598165128
Registry record updated Sep 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
NP14119 Issued in OH
Practice address
13422 Kinsman Rd
Cleveland, OH 44120-4410
Phone
(216) 283-4400
NPI assigned
Sep 2, 2014
Last updated
Sep 2, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NP14119 OH Primary

Addresses

Primary practice location

13422 Kinsman Rd
Cleveland, OH 44120-4410

Mailing address

1756 Sagamore Rd
Northfield, OH 44067-1086
Phone (330) 467-7131

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20160310002354 OH Practitioner - Nurse Practitioner 4284930686 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP14119OHMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Metrohealth System CurrentSince Feb 1, 2021 Accepting new patients
Murtis Taylor Human Services System CurrentSince Jan 30, 2016 Accepting new patients
The Metrohealth System CurrentSince Feb 1, 2021 Accepting new patients

Locations

13422 Kinsman Rd
Cleveland, OH 44120

2500 Metrohealth Dr
Cleveland, OH 44109
Phone (216) 778-2348

Organizations & group practices 3

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": "1409616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409616000000",
    "number": "1598165128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1756 SAGAMORE RD",
            "city": "NORTHFIELD",
            "state": "OH",
            "postal_code": "440671086",
            "telephone_number": "330-467-7131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13422 KINSMAN RD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441204410",
            "telephone_number": "216-283-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERRY",
        "first_name": "SHADINA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-02",
        "last_updated": "2014-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "NP14119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.