Individual provider Active NPI

Terry Lee Gourley, PA

  • Medical Physician Assistant
  • Hot Springs, SD
National Provider Identifier
1710014477
Registry record updated Mar 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
1151 Issued in SD
Practice address
500 N 5TH St
Hot Springs, SD 57747-1480
Phone
(605) 745-2000
Fax
(605) 745-2890
NPI assigned
Feb 28, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 1151 SD Primary
Medical Physician Assistant 363AM0700X 866 NE

Addresses

Primary practice location

500 N 5TH St
Hot Springs, SD 57747-1480

Mailing address

500 N 5TH St
Hot Springs, SD 57747-1480
Phone (605) 745-2000

Other identifiers 2

IdentifierTypeStateIssuer
866OtherNELICENSE
1029358OtherSDNCCPA CERT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130626000218 NE Order and Referring Only - Physician Assistant 0244318574

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
866NEMDPsychologist
1151SDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Frontier County Ambulance Service PastSince Apr 30, 2003 Accepting new patients

Organizations & group practices 1

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": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774569600000",
    "number": "1710014477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 N 5TH ST",
            "city": "HOT SPRINGS",
            "state": "SD",
            "postal_code": "577471480",
            "telephone_number": "605-745-2000",
            "fax_number": "605-745-2890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N 5TH ST",
            "city": "HOT SPRINGS",
            "state": "SD",
            "postal_code": "577471480",
            "telephone_number": "605-745-2000",
            "fax_number": "605-745-2890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOURLEY",
        "first_name": "TERRY",
        "middle_name": "LEE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-28",
        "last_updated": "2026-03-27",
        "certification_date": "2026-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "SD",
            "license": "1151",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NE",
            "license": "866",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "866",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCCPA CERT",
            "identifier": "1029358",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hot Springs, SD

Sources for this page

Verify at the official NPI Registry.