Terria Conwell

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

TERRIA CONWELL

Doing business as

ACL Medical Supply

Practice address

5835 Jessica Ave
Portage, IN 46368-1662

Phone

(219) 628-5672

NPI assigned

Jul 20, 2020

Last updated

Jul 20, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Terria ConwellNPI 1982243408

Title

Owner

Phone

(219) 628-5672

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• ACL Medical Supply Doing business as

Electronic endpoints 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Terria Conwell

  • In Home Supportive Care Agency
  • Portage, IN
  • NPI 1982243408

  Durable Medical Equipment & Medical Supplies

  NPD Authorized official

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

{
    "created_epoch": "1595203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595203200000",
    "number": "1679181218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5835 JESSICA AVE",
            "city": "PORTAGE",
            "state": "IN",
            "postal_code": "463681662",
            "telephone_number": "219-628-5672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5835 JESSICA AVE",
            "city": "PORTAGE",
            "state": "IN",
            "postal_code": "463681662",
            "telephone_number": "219-628-5672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TERRIA CONWELL",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-20",
        "last_updated": "2020-07-20",
        "certification_date": "2020-07-20",
        "status": "A",
        "authorized_official_last_name": "CONWELL",
        "authorized_official_first_name": "TERRIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "219-628-5672",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1699054080",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "onlinesoftware",
            "affiliation": "N",
            "endpointDescription": "onlinesoftware",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5835 Jessica Ave",
            "city": "Portage",
            "state": "IN",
            "country_code": "US",
            "postal_code": "463681662",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "ACL Medical Supply",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dean A. Szabo, O.D.
• Ronald William Szabo, O.D.
• Sreya Talasila, M.D.
• Shirley Taylor
• Sonya C Tener, COTA
• The Dialysis Center of Portage LLC (Portage Dialysis Center)
• The Woman's Wellness Center, P.C.
• The Wyndmoor of Portage, LLC
• Deborah Hoover Thomas, LCSW, LCAC
• Jenna M Thomas, PA-C

• Durable Medical Equipment & Medical Supplies in Portage, IN
• Providers in Portage, IN by specialty
• Durable Medical Equipment & Medical Supplies in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2020; 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.