Individual provider Active NPI

Gregory Scott Terrell, MD

  • Emergency Medical Services (Emergency Medicine) Physician
  • Tyler, TX
National Provider Identifier
1861400806
Registry record updated Jul 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
License
K1695 Issued in TX
Practice address
5201 S Broadway Ave Ste 200
Tyler, TX 75703-3748
Phone
(903) 595-6078
NPI assigned
Aug 4, 2006
Last updated
Jul 22, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X K1695 TX Primary

Addresses

Primary practice location

5201 S Broadway Ave Ste 200
Tyler, TX 75703-3748

Mailing address

108 W Clarksville St
Jefferson, TX 75657-1818
Phone (806) 420-7419

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 Medicine

State licenses

LicenseStateTypeSpecialty
19148OKMDPharmacist
K1695TXMDEmergency Medical Services (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Allied Pain Management Clinic, P.a. CurrentSince Oct 8, 2012 Accepting new patients
Bellville Hospital District Past Accepting new patients
Plateau Emergency Physicians Past Accepting new patients
Allied Pain Management Clinic P.a. PastSince Oct 8, 2012 Accepting new patients
Panhandle Emergency Physicians, P.a. Past Accepting new patients
Hale Emergency Medicine Associates, PA Past Accepting new patients
Van Buren Inc Past Accepting new patients
Texas Emergency Room Services PA Past Accepting new patients

Locations

5201 S Broadway Ave
Ste 200
Tyler, TX 75703
Phone (903) 595-6078

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311292800000",
    "number": "1861400806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 W CLARKSVILLE ST",
            "city": "JEFFERSON",
            "state": "TX",
            "postal_code": "756571818",
            "telephone_number": "806-420-7419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 S BROADWAY AVE STE 200",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757033748",
            "telephone_number": "903-595-6078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERRELL",
        "first_name": "GREGORY",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2011-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "TX",
            "license": "K1695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2011; 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.