Active NPI
Terri L Ponder, LCSW
- Clinical Social Worker
- Tullahoma, TN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 4623
- Practice address
- 1803 N Jackson St
Tullahoma, TN 37388-2201 - Phone
- (931) 461-1300
- NPI assigned
- Feb 7, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 4623 | TN | Primary |
Addresses
Primary practice location
1803 N Jackson St
Tullahoma, TN 37388-2201
Mailing address
1803 N Jackson St
Tullahoma, TN 37388-2201
Phone (931) 461-1300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LSW4623 | Other | TN | MEDICAL LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN, SC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
66 E Flagler St
Miami, FL 33130-1807
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medical Education Assistance Corporation | Current | Accepting new patients | |
| Grow Healthcare Group PA | Clinical | Current | Accepting new patients |
| Rutherford County Primary Care | Current | Accepting new patients |
Locations
170 Meeting St
Ste 110
Charleston, SC 29401
Phone (704) 610-1304
222 E Main St
Johnson City, TN 37604
Phone (423) 433-6200
1453 Hope Way
Murfreesboro, TN 37129
Phone (615) 893-9390
40 Burton Hills Blvd
Ste 200
Nashville, TN 37215
Phone (615) 257-8410
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.
-
- Internal Medicine Physician
- Johnson City, TN
- NPI 1235180480
-
- Federally Qualified Health Center (FQHC)
- Murfreesboro, TN
- NPI 1114973237
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1360195200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615161600000",
"number": "1679812895",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1803 N JACKSON ST",
"city": "TULLAHOMA",
"state": "TN",
"postal_code": "373882201",
"telephone_number": "931-461-1300",
"fax_number": "931-461-1302"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1803 N JACKSON ST",
"city": "TULLAHOMA",
"state": "TN",
"postal_code": "373882201",
"telephone_number": "931-461-1300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PONDER",
"first_name": "TERRI",
"middle_name": "L",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-02-07",
"last_updated": "2021-03-08",
"certification_date": "2021-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TN",
"license": "4623",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE",
"identifier": "LSW4623",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Tullahoma, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.