Individual provider Active NPI

Terrilyn Lewis, NP-C, MSN

  • Family Nurse Practitioner
  • McComb, MS
National Provider Identifier
1881797330
Registry record updated Nov 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R853385 Issued in MS
Practice address
405 Marion Ave
McComb, MS 39648-2709
Phone
(601) 684-1250
Fax
(601) 684-0129
NPI assigned
Sep 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R853385 MS Primary

Addresses

Primary practice location

405 Marion Ave
McComb, MS 39648-2709

Mailing address

405 Marion Ave
McComb, MS 39648-2709
Phone (601) 684-1250

Other identifiers 1

IdentifierTypeStateIssuer
08025742MedicaidMS

Other names 1

  • Terrilyn Leggett Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070713000466 MS Practitioner - Nurse Practitioner 5890895247 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southwest Mississippi Ear Nose and Throat Clinic PAGroup PAC ID 0244330686, 4 clinicians

Practice addresses (Care Compare)

405 Marion Ave
McComb, MS 39648-2709
Phone (601) 684-1250

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R853385MSMDFamily Nurse Practitioner

Organizations & group practices 1

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 1

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": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195430400000",
    "number": "1881797330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 MARION AVE",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396482709",
            "telephone_number": "601-684-1250",
            "fax_number": "601-684-0129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 MARION AVE",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396482709",
            "telephone_number": "601-684-1250",
            "fax_number": "601-684-0129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "TERRILYN",
        "name_prefix": "Mrs.",
        "credential": "NP-C, MSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-07",
        "last_updated": "2007-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R853385",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08025742",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TERRILYN",
            "last_name": "LEGGETT",
            "credential": "NP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in McComb, MS

Sources for this page

Verify at the official NPI Registry.