Individual provider Active NPI

Justin Daniel Terrell, M.D.

  • Family Medicine Physician
  • Gravois Mills, MO
National Provider Identifier
1689986275
Registry record updated Aug 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2013026811 Issued in MO
Practice address
401 N Main St
Gravois Mills, MO 65037-6253
Phone
(877) 406-2662
Fax
(573) 207-2773
NPI assigned
Jul 12, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 2013026811 MO Primary

Addresses

Primary practice location

401 N Main St
Gravois Mills, MO 65037-6253

Mailing address

401 N Main St
Gravois Mills, MO 65037-6253
Phone (877) 406-2662

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130730000160 MO Practitioner - General PracticePractitioner - Family Practice 6507007895 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Richland Medical Center, Inc.Group PAC ID 2062554025, 29 clinicians

Practice addresses (Care Compare)

401 N Main St
Gravois Mills, MO 65037-6253
Phone (877) 406-2662

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
State of Missouri Multi-Specialty CurrentSince Nov 1, 2021 Accepting new patients
State of Missouri Multi-Specialty CurrentSince Nov 1, 2021 Accepting new patients
Ozarks Medical Center Multi-Specialty Past Accepting new patients
Richland Medical Center, Inc. Past Accepting new patients

Locations

600 E 5th St
Fulton, MO 65251
Phone (573) 592-2623

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1278892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755043200000",
    "number": "1689986275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 N MAIN ST",
            "city": "GRAVOIS MILLS",
            "state": "MO",
            "postal_code": "650376253",
            "telephone_number": "877-406-2662",
            "fax_number": "573-207-2773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 N MAIN ST",
            "city": "GRAVOIS MILLS",
            "state": "MO",
            "postal_code": "650376253",
            "telephone_number": "877-406-2662",
            "fax_number": "573-207-2773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERRELL",
        "first_name": "JUSTIN",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-12",
        "last_updated": "2025-08-13",
        "certification_date": "2025-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2013026811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gravois Mills, MO

Sources for this page

Verify at the official NPI Registry.