Individual provider Active NPI

Llewellyn E. Terry

  • Case Manager/Care Coordinator
  • Arkadelphia, AR
National Provider Identifier
1619459237
Registry record updated Aug 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
2607 Caddo St Ste 6
Arkadelphia, AR 71923-5307
Phone
(870) 230-8217
Fax
(870) 230-8201
NPI assigned
Aug 30, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

2607 Caddo St Ste 6
Arkadelphia, AR 71923-5307

Mailing address

2607 Caddo St Ste 6
Arkadelphia, AR 71923-5307
Phone (870) 230-8217

Other identifiers 1

IdentifierTypeStateIssuer
181395526MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Arkansas Counseling and Psychodiagnostics, Inc. PastSince Dec 22, 2020 Accepting new patients
Arkansas Counseling and Psychodiagnostics, Inc. Past Accepting new patients

Organizations & group practices 2

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": "1535587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535587200000",
    "number": "1619459237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2607 CADDO ST STE 6",
            "city": "ARKADELPHIA",
            "state": "AR",
            "postal_code": "719235307",
            "telephone_number": "870-230-8217",
            "fax_number": "870-230-8201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2607 CADDO ST STE 6",
            "city": "ARKADELPHIA",
            "state": "AR",
            "postal_code": "719235307",
            "telephone_number": "870-230-8217",
            "fax_number": "870-230-8201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERRY",
        "first_name": "LLEWELLYN",
        "middle_name": "E.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-08-30",
        "last_updated": "2018-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "181395526",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arkadelphia, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2018; 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.