Individual provider Active NPI

Terence Anthony Alexander, M.D.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Avondale, AZ
National Provider Identifier
1629028410
Registry record updated Nov 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
51325 Issued in AZ
Practice address
10450 W McDowell Rd
Suite 102
Avondale, AZ 85392-4901
Phone
(623) 846-7614
Fax
(623) 846-0993
NPI assigned
May 11, 2006
Last updated
Nov 3, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 27628 IA
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 29782 WI
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 51325 AZ Primary

Addresses

Primary practice location

10450 W McDowell Rd
Suite 102
Avondale, AZ 85392-4901

Mailing address

PO Box 271429
Salt Lake City, UT 84127-1429
Phone (602) 772-3800

Other identifiers 1

IdentifierTypeStateIssuer
0064337MedicaidIA

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
51325AZMDSports Medicine (Orthopaedic Surgery) Physician
29782WIMDSports Medicine (Orthopaedic Surgery) Physician

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478131200000",
    "number": "1629028410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 271429",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841271429",
            "telephone_number": "602-772-3800",
            "fax_number": "602-772-3801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10450 W MCDOWELL RD",
            "address_2": "SUITE 102",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853924901",
            "telephone_number": "623-846-7614",
            "fax_number": "623-846-0993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALEXANDER",
        "first_name": "TERENCE",
        "middle_name": "ANTHONY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2016-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "IA",
            "license": "27628",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "WI",
            "license": "29782",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "AZ",
            "license": "51325",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0064337",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Avondale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2016; 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.