Active NPI
Terry Elliot Passman, MD
- Addiction Psychiatry Physician
- Fairhope, AL
National Provider Identifier
1740287325
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction Psychiatry Physician
- License
- 18468
- Practice address
- 208 Greeno Rd N Ste D2
Fairhope, AL 36532-3057 - Phone
- (251) 928-4750
- Fax
- (251) 990-2560
- NPI assigned
- Jun 28, 2005
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Addiction Psychiatry Physician | 2084P0802X | 18468 | AL | Primary |
Addresses
Primary practice location
208 Greeno Rd N Ste D2
Fairhope, AL 36532-3057
Mailing address
208 Greeno Rd N Ste D2
Fairhope, AL 36532-3057
Phone (251) 928-4750
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Feb 9, 2016 through Feb 9, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18468 | AL | MD | Addiction Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119916800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1652918400000",
"number": "1740287325",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "208 GREENO RD N STE D2",
"city": "FAIRHOPE",
"state": "AL",
"postal_code": "365323057",
"telephone_number": "251-928-4750",
"fax_number": "251-990-2560"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "208 GREENO RD N STE D2",
"city": "FAIRHOPE",
"state": "AL",
"postal_code": "365323057",
"telephone_number": "251-928-4750",
"fax_number": "251-990-2560"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PASSMAN",
"first_name": "TERRY",
"middle_name": "ELLIOT",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-06-28",
"last_updated": "2022-05-19",
"certification_date": "2022-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0802X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Addiction Psychiatry",
"state": "AL",
"license": "18468",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairhope, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2022; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.