Individual provider Active NPI

William K Terry, D.C.

  • Chiropractor
  • Jacksonville, FL
National Provider Identifier
1740314160
Registry record updated Nov 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH0004235 Issued in FL
Practice address
9905 Old Saint Augustine Rd Ste 504
Jacksonville, FL 32257-8856
Phone
(904) 886-3118
Fax
(904) 886-3119
NPI assigned
Mar 15, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH0004235 FL Primary

Addresses

Primary practice location

9905 Old Saint Augustine Rd Ste 504
Jacksonville, FL 32257-8856

Mailing address

9905 Old Saint Augustine Rd Ste 504
Jacksonville, FL 32257-8856
Phone (904) 886-3118

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041221000690 FL Practitioner - Chiropractic 2961460084 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9905 Old Saint Augustine Rd
Suite 504
Jacksonville, FL 32257-8856
Phone (904) 886-3118

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH0004235FLMDChiropractor

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": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352764800000",
    "number": "1740314160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9905 OLD SAINT AUGUSTINE RD STE 504",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322578856",
            "telephone_number": "904-886-3118",
            "fax_number": "904-886-3119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9905 OLD SAINT AUGUSTINE RD STE 504",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322578856",
            "telephone_number": "904-886-3118",
            "fax_number": "904-886-3119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERRY",
        "first_name": "WILLIAM",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-15",
        "last_updated": "2012-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH0004235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.