Active NPI
Gregory Scott Terrell, MD
- Emergency Medical Services (Emergency Medicine) Physician
- Tyler, TX
National Provider Identifier
1861400806
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medical Services (Emergency Medicine) Physician
- License
- K1695
- 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, 2011
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 19148 | OK | MD | Pharmacist |
| K1695 | TX | MD | Emergency Medical Services (Emergency Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Allied Pain Management Clinic, P.a. | Current | Accepting new patients | |
| Bellville Hospital District | Past | Accepting new patients | |
| Plateau Emergency Physicians | Past | Accepting new patients | |
| Allied Pain Management Clinic P.a. | Past | 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.
-
- Orthopedic Chiropractor
- Tyler, TX
- NPI 1669420345
-
- Family Medicine Physician
- Tyler, TX
- NPI 1568658920
-
dba Bellville General Hospital
- General Acute Care Hospital
- Bellville, TX
- NPI 1457358103
-
- Emergency Medicine Physician
- Plainview, TX
- NPI 1649255829
-
- Emergency Medicine Physician
- Amarillo, TX
- NPI 1629020870
-
- Emergency Medicine Physician
- Borger, TX
- NPI 1942250121
-
- Emergency Medicine Physician
- Enumclaw, WA
- NPI 1497785315
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.