Individual provider Active NPI

Jamelah Aelon Terry, MD

  • Pediatrics Physician
  • Baltimore, MD
National Provider Identifier
1598959199
Registry record updated Nov 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
D76332 Issued in MD
Practice address
900 Caton Ave
Mailbox 081
Baltimore, MD 21229-5201
Phone
(443) 703-3200
Fax
(443) 703-3201
NPI assigned
Aug 28, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD28229 AL
Pediatrics Physician 208000000X D76332 MD Primary

Addresses

Primary practice location

900 Caton Ave
Mailbox 081
Baltimore, MD 21229-5201

Mailing address

3501 Sinclair LN
Baltimore, MD 21213-2029
Phone (410) 732-8800

Other identifiers 1

IdentifierTypeStateIssuer
MD28229OtherALSTATE LICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20140820001707 MD Practitioner - Pediatric Medicine 1355569104 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD28229ALMDPediatrics Physician
D76332MDMDPediatrics Physician

Interoperability endpoints

  • Direct secure messaging: jamelah.terry.p1@direct.bmsi.nextgenshare.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1188259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447113600000",
    "number": "1598959199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3501 SINCLAIR LN",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212132029",
            "telephone_number": "410-732-8800",
            "fax_number": "410-534-2392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 CATON AVE",
            "address_2": "MAILBOX 081",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212295201",
            "telephone_number": "443-703-3200",
            "fax_number": "443-703-3201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERRY",
        "first_name": "JAMELAH",
        "middle_name": "AELON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-28",
        "last_updated": "2015-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AL",
            "license": "MD28229",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D76332",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "MD28229",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.