Mark A Terry, MD

Primary specialty

Radiological Physics PhysicianTaxonomy code 2085R0205X

License

MD00017547 Issued in WA

Practice address

415 6TH St
Lewiston, ID 83501-2431

Phone

(208) 799-5335

NPI assigned

May 4, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Phoenix Radiology, PLLC

  • Vascular & Interventional Radiology Physician
  • Lewiston, ID
  • NPI 1164493334
  NPD (past)
• Spokane Advanced Imaging Institute , LLC

  • Radiology Clinic/Center
  • Spokane, WA
  • NPI 1144345711
  NPD (past)
• Spokane Radiology Consultants, PS

  • Specialist
  • Spokane, WA
  • NPI 1700928744
  NPD (past)

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225843200000",
    "number": "1649228446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "531 4TH AVE",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835012450",
            "telephone_number": "208-743-4393",
            "fax_number": "208-743-4214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 6TH ST",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835012431",
            "telephone_number": "208-799-5335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERRY",
        "first_name": "MARK",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2008-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0205X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiological Physics",
            "state": "WA",
            "license": "MD00017547",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DLI",
            "identifier": "0227614",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRAVELERS/RAILROAD MEDICARE",
            "identifier": "P00468202",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8255408",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003973900",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IDAHO",
            "identifier": "77142",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD OF IDAHO",
            "identifier": "000010165165",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daniel York Taylor, OTR
• Anthony Brian Tenny, CADC
• Samuel Tepper, D.V.M.
• Larry Alan Terherst, MS, LCPC
• Robert Ernest Terrell
• Laura Thayer, LCPC
• The Breast Nurse LLC
• Therapy Works, PLLC
• Amy Thomas, LCSW
• Christine Ann Thomas, PMHNP-BC

• Radiological Physics Physician in Lewiston, ID
• Providers in Lewiston, ID by specialty
• Radiological Physics Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2008; 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.