Active NPI
Melody Ann Terry, FNP
- Family Nurse Practitioner
- Columbia, IL
National Provider Identifier
1790554137
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 2023048403
- Practice address
- 307 Westpark Drive
Columbia, IL 62236 - Phone
- (618) 910-8493
- NPI assigned
- Dec 27, 2023
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 2023048403 | MO | Primary |
Addresses
Primary practice location
307 Westpark Drive
Columbia, IL 62236
Mailing address
307 Westpark Drive
Columbia, IL 62236
Phone (618) 910-8493
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2023048403 | MO | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1703635200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1703635200000",
"number": "1790554137",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "307 WESTPARK DRIVE",
"city": "COLUMBIA",
"state": "IL",
"postal_code": "62236",
"telephone_number": "618-910-8493"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "307 WESTPARK DRIVE",
"city": "COLUMBIA",
"state": "IL",
"postal_code": "62236",
"telephone_number": "618-910-8493"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TERRY",
"first_name": "MELODY",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-12-27",
"last_updated": "2023-12-27",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MO",
"license": "2023048403",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbia, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.