Active NPI
Terry Joseph Nold, D.O.
- Internal Medicine Physician
- Jefferson City, MO
National Provider Identifier
1841306917
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 36677
- Practice address
- 1111 Madison St
Jefferson City, MO 65101-2753 - Phone
- (573) 635-7651
- Fax
- (573) 659-4515
- NPI assigned
- Aug 22, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 36677 | MO | Primary |
Addresses
Primary practice location
1111 Madison St
Jefferson City, MO 65101-2753
Mailing address
1111 Madison St
Jefferson City, MO 65101-2753
Phone (573) 635-7651
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 119187 | Other | MO | HEALTHLINK |
| 4457922 | Other | MO | AETNA INSURANCE |
| 04-04022 | Other | MO | UNITED HEALTH CARE |
| 106271 | Other | MO | MERCY HEALTH PLANS |
| 10503A001 | Other | MO | BLUE CROSS/BLUE SHIELD |
| 25016 | Other | MO | BLUE CHOICE |
| 13045 | Other | MO | GROUP HEALTH PLAN |
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)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36677 | MO | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1188432000000",
"number": "1841306917",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1111 MADISON ST",
"city": "JEFFERSON CITY",
"state": "MO",
"postal_code": "651012753",
"telephone_number": "573-635-7651",
"fax_number": "573-659-4515"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1111 MADISON ST",
"city": "JEFFERSON CITY",
"state": "MO",
"postal_code": "651012753",
"telephone_number": "573-635-7651",
"fax_number": "573-659-4515"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOLD",
"first_name": "TERRY",
"middle_name": "JOSEPH",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-22",
"last_updated": "2007-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MO",
"license": "36677",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHLINK",
"identifier": "119187",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA INSURANCE",
"identifier": "4457922",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTH CARE",
"identifier": "04-04022",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MERCY HEALTH PLANS",
"identifier": "106271",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS/BLUE SHIELD",
"identifier": "10503A001",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CHOICE",
"identifier": "25016",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP HEALTH PLAN",
"identifier": "13045",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jefferson City, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.