Individual provider Active NPI

Terry Michael Brown, DO

  • Sleep Medicine (Psychiatry & Neurology) Physician
  • Marion, IL
National Provider Identifier
1811085293
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084S0012X
License
036109663 Issued in IL
Practice address
8305 Express Dr Ste C
Marion, IL 62959-7771
Phone
(618) 993-0086
Fax
(618) 993-0088
NPI assigned
Oct 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Sleep Medicine (Psychiatry & Neurology) Physician 2084S0012X 14699 MS
Sleep Medicine (Psychiatry & Neurology) Physician 2084S0012X DO-264 AL
Sleep Medicine (Psychiatry & Neurology) Physician 2084S0012X 028735 GA
Sleep Medicine (Psychiatry & Neurology) Physician 2084S0012X 29462 NC
Sleep Medicine (Psychiatry & Neurology) Physician 2084S0012X 036109663 IL Primary

Addresses

Primary practice location

8305 Express Dr Ste C
Marion, IL 62959-7771

Mailing address

PO Box 1433
Murphysboro, IL 62966-1433
Phone (618) 993-0086

Other practice location 1

2 S Hospital Dr
Murphysboro, IL 62966-3333
Phone (618) 529-0543

Other identifiers 8

IdentifierTypeStateIssuer
P00118900OtherILRAILROAD MEDICARE- PIN
0723320MedicaidIA
3932015OtherILBLUECROSS BLUESHIELD OF ILLINOIS
208084OtherILMEDICARE- GROUP NUMBER
DF5180OtherILRAILROAD MEDICARE- GROUP NUMBER
036109663MedicaidIL
088817OtherILHEALTH ALLIANCE
660328OtherILHEALTHLINK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040316000934 IL Practitioner - Sleep MedicinePractitioner - NeurologyPractitioner - Psychiatry 8527958453 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Sleep MedicineAlso: Psychiatry
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Massac Memorial HospitalGroup PAC ID 3072422799, 15 clinicians

Practice addresses (Care Compare)

1204 W 10TH St
Metropolis, IL 62960-2480
Phone (618) 524-3572

2 S Hospital Dr
Murphysboro, IL 62966-3333
Phone (618) 529-0543

8305 Express Dr
Suite C
Marion, IL 62959-7771
Phone 618993008655461

PO Box
Suite 1433
Murphysboro, IL 62966-3333

Hospital & facility affiliations

  • Massac Memorial Hospital Hospital, Metropolis, IL, CCN 141323
  • Memorial Hospital Hospital, Chester, IL, CCN 141338

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
DO-264ALMDSleep Medicine (Psychiatry & Neurology) Physician
028735GAMDSleep Medicine (Psychiatry & Neurology) Physician
14699MSMDSleep Medicine (Psychiatry & Neurology) Physician
29462NCMDSleep Medicine (Psychiatry & Neurology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Massac Memorial Hospital CurrentSince Feb 1, 2018 Accepting new patients
Massac Memorial Hospital CurrentSince Feb 1, 2018 Accepting new patients
Massac Memorial Hospital Current Accepting new patients
Granite City Hospitalist Services LLC CurrentSince Jun 1, 2017 Accepting new patients
Massac Memorial Hospital Current Accepting new patients
Hospital Authority of Valdosta and Lowndes County, Georgia Past Accepting new patients
Massac Memorial Hospital Past Accepting new patients
Family Practice Associates, PC Past Accepting new patients

Locations

2250 N Illinois Ave
Carbondale, IL 62901
Phone (618) 833-1691

2100 Madison Ave
Granite City, IL 62040
Phone (618) 798-3000

1204 W 10th St
Ste Ab
Metropolis, IL 62960
Phone (618) 524-2176

28 Chick St
Metropolis, IL 62960
Phone (618) 427-2680

1204 W 10th St
Ste C
Metropolis, IL 62960
Phone (618) 524-2182

1204 W 10th St
Ste A
Metropolis, IL 62960
Phone (618) 524-3572

1204 W 10th St
Ste B
Metropolis, IL 62960

Interoperability endpoints

  • Direct secure messaging: terrybrown@massac.medalliesdirect.net
  • Direct secure messaging: tbrown15591@sih.direct-ci.com
  • Direct secure messaging: tbrow244@yourcarecommunity.org

Organizations & group practices 10

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1811085293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1433",
            "city": "MURPHYSBORO",
            "state": "IL",
            "postal_code": "629661433",
            "telephone_number": "618-993-0086",
            "fax_number": "215-895-3005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8305 EXPRESS DR STE C",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629597771",
            "telephone_number": "618-993-0086",
            "fax_number": "618-993-0088"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 S Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Murphysboro",
            "state": "IL",
            "postal_code": "629663333",
            "country_code": "US",
            "telephone_number": "618-529-0543",
            "fax_number": "215-895-3005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "TERRY",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084S0012X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Sleep Medicine",
            "state": "MS",
            "license": "14699",
            "primary": false
        },
        {
            "code": "2084S0012X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Sleep Medicine",
            "state": "AL",
            "license": "DO-264",
            "primary": false
        },
        {
            "code": "2084S0012X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Sleep Medicine",
            "state": "GA",
            "license": "028735",
            "primary": false
        },
        {
            "code": "2084S0012X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Sleep Medicine",
            "state": "NC",
            "license": "29462",
            "primary": false
        },
        {
            "code": "2084S0012X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Sleep Medicine",
            "state": "IL",
            "license": "036109663",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE- PIN",
            "identifier": "P00118900",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0723320",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD OF ILLINOIS",
            "identifier": "3932015",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE- GROUP NUMBER",
            "identifier": "208084",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE- GROUP NUMBER",
            "identifier": "DF5180",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036109663",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE",
            "identifier": "088817",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "660328",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, IL

Sources for this page

Verify at the official NPI Registry.