NPIMap

Individual provider Active NPI

Terry W Henrie, PA-C

  • Family Medicine Physician
  • Philip, SD
National Provider Identifier
1689644098
Registry record updated Jun 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0581 Issued in SD
Practice address
503 W Pine St
Philip, SD 57567-3300
Phone
(605) 859-2566
Fax
(605) 859-2948
NPI assigned
Jan 26, 2006
Last updated
Jun 24, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0581 SD Primary

Addresses

Primary practice location

503 W Pine St
Philip, SD 57567-3300

Mailing address

503 W Pine St
PO Box 550
Philip, SD 57567-3300
Phone (605) 859-2566

Other identifiers 1

IdentifierTypeStateIssuer
6827660MedicaidSD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041109000430 SD Practitioner - Physician Assistant 7517920705 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Philip Health Services IncGroup PAC ID 7214831866, 6 clinicians

Practice addresses (Care Compare)

503 W Pine St
Philip, SD 57567-3300
Phone (605) 859-2566

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0581SDMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Philip Health Services, Inc. CurrentSince Oct 1, 2004 Accepting new patients
Philip Clinic PastSince Mar 28, 2021 Accepting new patients

Locations

503 W Pine St
Philip, SD 57567
Phone (605) 859-2511

Organizations & group practices 4

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.

Hospital & facility affiliations 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214265600000",
    "number": "1689644098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 W PINE ST",
            "address_2": "PO BOX 550",
            "city": "PHILIP",
            "state": "SD",
            "postal_code": "575673300",
            "telephone_number": "605-859-2566",
            "fax_number": "605-859-2948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 W PINE ST",
            "city": "PHILIP",
            "state": "SD",
            "postal_code": "575673300",
            "telephone_number": "605-859-2566",
            "fax_number": "605-859-2948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRIE",
        "first_name": "TERRY",
        "middle_name": "W",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-26",
        "last_updated": "2008-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SD",
            "license": "0581",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6827660",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philip, SD

Sources for this page

Verify at the official NPI Registry.