NPIMap

Individual provider Active NPI

Terry Lee Everhart, MD

  • Family Medicine Physician
  • Edgewater, MD
National Provider Identifier
1861653404
Registry record updated Apr 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
D72318 Issued in MD
Practice address
3169 Braverton Street
Suite 201
Edgewater, MD 21037-2690
Phone
(410) 956-4911
Fax
(410) 956-4935
NPI assigned
Jun 17, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2010-01890 NC
Family Medicine Physician 207Q00000X 149428 NC
Family Medicine Physician 207Q00000X D72318 MD Primary

Addresses

Primary practice location

3169 Braverton Street
Suite 201
Edgewater, MD 21037-2690

Mailing address

PO Box 12622
Belfast, ME 04915-4017
Phone (443) 481-6480

Other identifiers 5

IdentifierTypeStateIssuer
043456600MedicaidMD
97518901OtherMDBCBS
K6430005OtherDCBCBS
9140763OtherMDAETNA PPO
8082731OtherMDAETNA HMO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110801000848 MD Practitioner - Family Practice 9234308669 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of North Carolina at Chapel Hill School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Luminis Health Medical Group, LLCGroup PAC ID 2860447315, 540 clinicians

Practice addresses (Care Compare)

3169 Braverton St
Suite 201
Edgewater, MD 21037-2690
Phone (410) 956-4911

Hospital & facility affiliations

  • Amedisys Home Health of Maryland Home health agency, Glen Burnie, MD, CCN 217108
  • The Johns Hopkins Home Health Services, Inc Home health agency, Baltimore, MD, CCN 217081
  • Bayada Home Health Care, Inc. Home health agency, Towson, MD, CCN 217101
  • Centerwell Home Health Home health agency, Columbia, MD, CCN 217071
  • Luminis Health Anne Arundel Medical Center, Inc Hospital, Annapolis, MD, CCN 210023

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D72318MDMDFamily Medicine Physician
149428NCMDFamily Medicine Physician
2010-01890NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Luminis Health Medical Group, LLC CurrentSince Jul 11, 2011 Accepting new patients
Luminis Health Medical Group, LLC Current Accepting new patients
Luminis Health Medical Group, LLC CurrentSince Jul 11, 2011 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

2003 Medical Pkwy
Ste 301
Annapolis, MD 21401
Phone (443) 481-3366

1630 Main St
Ste 213
Chester, MD 21619
Phone (443) 481-5300

28438 Marlboro Ave
Easton, MD 21601
Phone (410) 820-7270

3169 Braverton St
Ste 201
Edgewater, MD 21037
Phone (410) 956-4911

Interoperability endpoints

  • Direct secure messaging: teverhart21412@direct.aahs.org

Organizations & group practices 4

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 9

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": "1213660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427846400000",
    "number": "1861653404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12622",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049154017",
            "telephone_number": "443-481-6480",
            "fax_number": "443-481-6515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3169 BRAVERTON STREET",
            "address_2": "SUITE 201",
            "city": "EDGEWATER",
            "state": "MD",
            "postal_code": "210372690",
            "telephone_number": "410-956-4911",
            "fax_number": "410-956-4935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVERHART",
        "first_name": "TERRY",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-17",
        "last_updated": "2015-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2010-01890",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "149428",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D72318",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "043456600",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "97518901",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "K6430005",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "9140763",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "8082731",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edgewater, MD

Sources for this page

Verify at the official NPI Registry.