Active NPI
Terri L. Anderson, PA-C
- Surgical Physician Assistant
- Eglin AFB, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- PA 9107825
- Practice address
- 307 Boatner Rd Ste 114
Eglin AFB, FL 32542-1302 - Phone
- (850) 883-8345
- NPI assigned
- Oct 23, 2005
- Last updated
- Jun 12, 2015
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | PA 9107825 | FL | Primary |
Addresses
Primary practice location
307 Boatner Rd Ste 114
Eglin AFB, FL 32542-1302
Mailing address
4038 Lauren CT
Destin, FL 32541-2127
Phone (850) 621-2447
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3336 S 4155
West Valley City, UT 84120
82 S 1100
Suite 103
Salt Lake City, UT 84102-1889
Phone (801) 505-5370
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA 9107825 | FL | MD | Surgical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Catholic Health Initiatives Colorado | Current | Accepting new patients | |
| Physician Group of Utah Inc | Current | Accepting new patients | |
| Catholic Health Initiatives Colorado | Current | Accepting new patients | |
| Catholic Health Initiatives Colorado | Past | Accepting new patients |
Locations
9100 E Mineral Cir
Centennial, CO 80112
Phone (303) 561-5193
6322 S 3000 E
Ste 140
Salt Lake City, UT 84121
Phone (801) 733-9924
82 S 1100 E
Ste 303
Salt Lake Cty, UT 84102
Phone (801) 533-2002
82 S 1100 E
Ste 103
Salt Lake Cty, UT 84102
Phone (801) 505-5370
2530 W 4700 S
Ste B8
Taylorsville, UT 84129
Phone (801) 967-5866
3584 W 9000 S
Ste 405
West Jordan, UT 84088
Phone (801) 568-3480
3580 W 90th S
West Jordan, UT 84088
Phone (801) 263-0810
Organizations & group practices 5
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.
-
dba Behavioral Health West Valley
- Prescribing (Medical) Psychologist
- West Valley City, UT
- NPI 1942903562
-
- Specialist
- South Jordan, UT
- NPI 1477676930
-
dba GTWJ Gastro W Jor
- Gastroenterology Physician
- West Jordan, UT
- NPI 1063114312
-
dba CommonSpirit Orthopedics Longmont
- Orthopaedic Surgery Physician
- Longmont, CO
- NPI 1891675294
-
dba NSSH Neurosurg Sah
- Neurological Surgery Physician
- Lakewood, CO
- NPI 1205846664
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Holy Cross Hospital - Jordan Valley
- General Acute Care Hospital
- West Jordan, UT
- NPI 1801591391
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130025600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1434067200000",
"number": "1902896848",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4038 LAUREN CT",
"city": "DESTIN",
"state": "FL",
"postal_code": "325412127",
"telephone_number": "850-621-2447"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "307 BOATNER RD STE 114",
"city": "EGLIN AFB",
"state": "FL",
"postal_code": "325421302",
"telephone_number": "850-883-8345"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "TERRI",
"middle_name": "L.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-10-23",
"last_updated": "2015-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "FL",
"license": "PA 9107825",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Eglin AFB, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.