Individual provider Active NPI

Joseph G Terry, PT

  • Physical Therapist
  • Moline, IL
National Provider Identifier
1639139884
Registry record updated Jan 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070008578 Issued in IL
Practice address
850 43Rd Ave Ste 100
Moline, IL 61265-8401
Phone
(309) 743-2070
Fax
(309) 743-2073
NPI assigned
Mar 23, 2006
Last updated
Jan 5, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070008578 IL Primary

Addresses

Primary practice location

850 43Rd Ave Ste 100
Moline, IL 61265-8401

Mailing address

1003 N Cummings LN
Washington, IL 61571-9646
Phone (309) 444-1030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051219000324 IL Practitioner - Physical Therapist in Private Practice 8729009790 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1013 N Cummings LN
Washington, IL 61571-9646
Phone (309) 444-1030

850 43Rd Ave
Moline, IL 61265-8401

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rock Valley Physical Therapy Center Physical Therapist CurrentSince Jan 5, 2014 Accepting new patients
Rock Valley Physical Therapy Center Physical Therapist CurrentSince Jan 5, 2014 Accepting new patients

Locations

850 43rd Ave
Ste 100
Moline, IL 61265
Phone (309) 743-2070

850 43rd Ave
Ste 200
Moline, IL 61265
Phone (309) 743-0300

850 43rd Ave
Ste 300
Moline, IL 61265
Phone (309) 743-0300

9901 N Knoxville Ave
Ste D
Peoria, IL 61615
Phone (309) 243-1989

1003 N Cummings Ln
Washington, IL 61571
Phone (309) 444-1000

1013 N Cummings Ln
Washington, IL 61571
Phone (309) 444-1030

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, 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": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420416000000",
    "number": "1639139884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 N CUMMINGS LN",
            "city": "WASHINGTON",
            "state": "IL",
            "postal_code": "615719646",
            "telephone_number": "309-444-1030",
            "fax_number": "309-444-1060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 43RD AVE STE 100",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612658401",
            "telephone_number": "309-743-2070",
            "fax_number": "309-743-2073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERRY",
        "first_name": "JOSEPH",
        "middle_name": "G",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2015-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070008578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moline, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.