Individual provider Active NPI

Gregory Terry, BA.

  • Case Manager/Care Coordinator
  • Seattle, WA
National Provider Identifier
1770021362
Registry record updated Feb 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
License
CG 60148789 Issued in WA
Practice address
11000 Lake City Way NE
Seattle, WA 98125-6748
Phone
(206) 604-7501
NPI assigned
Feb 3, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X CG 60148789 WA Primary

Addresses

Primary practice location

11000 Lake City Way NE
Seattle, WA 98125-6748

Mailing address

1604 42ND St NE
Auburn, WA 98002-7101
Phone (206) 778-2939

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Bachelor of Arts

State licenses

LicenseStateTypeSpecialty
CG 60148789WAMDCase Manager/Care Coordinator

NPI Registry JSON

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

{
    "created_epoch": "1486080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486080000000",
    "number": "1770021362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1604 42ND ST NE",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980027101",
            "telephone_number": "206-778-2939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11000 LAKE CITY WAY NE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981256748",
            "telephone_number": "206-604-7501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERRY",
        "first_name": "GREGORY",
        "name_prefix": "Mr.",
        "credential": "BA.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-02-03",
        "last_updated": "2017-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "WA",
            "license": "CG 60148789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.