Individual provider Active NPI

Renea L Nagel-Terrell, CFNP

  • Family Nurse Practitioner
  • Union City, TN
National Provider Identifier
1619977584
Registry record updated Jan 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN 6675 Issued in TN
Practice address
701 E Reelfoot Ave
Suite 100
Union City, TN 38261-5880
Phone
(731) 885-9687
Fax
(731) 885-6643
NPI assigned
Jul 21, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 25, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN92056 TN
Family Nurse Practitioner 363LF0000X APN 6675 TN Primary

Addresses

Primary practice location

701 E Reelfoot Ave
Suite 100
Union City, TN 38261-5880

Mailing address

701 E Reelfoot Ave
Suite 100
Union City, TN 38261-5880
Phone (731) 885-9687

Other identifiers 1

IdentifierTypeStateIssuer
1504900MedicaidTN

Other names 1

  • Renea Nagel Terrell Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20040922000250 TN Practitioner - Nurse Practitioner 3870561301 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Terrell Clinic, LLCGroup PAC ID 6204912645, 3 clinicians

Practice addresses (Care Compare)

1430 Friar Tuck Dr
Union City, TN 38261-1912

701 E Reelfoot Ave
Suite 100
Union City, TN 38261-5882

701 E Reelfoot Ave
Suite 100
Union City, TN 38261-5886
Phone (731) 885-9687

Hospital & facility affiliations

  • Baptist Memorial Hospital Union City Hospital, Union City, TN, CCN 440130

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6675TNMDOccupational Therapist
RN92056TNMDNurse Practitioner
APN 6675TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Terrell Clinic LLC Family CurrentSince Mar 1, 2008 Accepting new patients
Boston Cancer Group, PLC Past Accepting new patients
Emergency Coverage Services, PC Nurse Practitioner Past Accepting new patients

Locations

701 E Reelfoot Ave
Ste 100
Union City, TN 38261
Phone (731) 885-2235

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Terrell Clinic, LLCUnion City, TN, CCN 448916 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
W-2 Managing Employee (100%)
Operational/Managerial Control (100%)
Jun 1, 2012
Jun 1, 2012
Jun 1, 2012

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1121904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264377600000",
    "number": "1619977584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 E REELFOOT AVE",
            "address_2": "SUITE 100",
            "city": "UNION CITY",
            "state": "TN",
            "postal_code": "382615880",
            "telephone_number": "731-885-9687",
            "fax_number": "731-885-6643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 E REELFOOT AVE",
            "address_2": "SUITE 100",
            "city": "UNION CITY",
            "state": "TN",
            "postal_code": "382615880",
            "telephone_number": "731-885-9687",
            "fax_number": "731-885-6643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAGEL-TERRELL",
        "first_name": "RENEA",
        "middle_name": "L",
        "credential": "CFNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-21",
        "last_updated": "2010-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "RN92056",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "APN 6675",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1504900",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RENEA",
            "last_name": "TERRELL",
            "middle_name": "NAGEL",
            "credential": "CFNP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Union City, TN

Sources for this page

Verify at the official NPI Registry.