Raymond C Tervo, MD

Primary specialty

Pediatric Neurodevelopmental Disabilities PhysicianTaxonomy code 2080P0008X

License

01077656A Issued in IN

Practice address

3900 Washington Ave Ste 100
Evansville, IN 47714

Phone

(812) 485-6694

NPI assigned

Oct 18, 2006

Last updated

Aug 13, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534118400000",
    "number": "1912088550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13059",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049154021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 WASHINGTON AVE STE 100",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "47714",
            "telephone_number": "812-485-6694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERVO",
        "first_name": "RAYMOND",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2018-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "40431",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01077656A",
            "primary": false
        },
        {
            "code": "2080P0008X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neurodevelopmental Disabilities",
            "state": "IN",
            "license": "01077656A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "931227700",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Ciara Terry
• Mark Tesanovich
• Jenna L Thacker, OT
• Terry Brandon Thacker, M.D.
• Killol J Thakore, MD
• Patricia W Tharp, M.D.

• Pediatric Neurodevelopmental Disabilities Physician in Evansville, IN
• Providers in Evansville, IN by specialty
• Pediatric Neurodevelopmental Disabilities Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2018; 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.