Individual provider Active NPI

Thomas L Terry, M.D.

  • Specialist
  • Macon, GA
National Provider Identifier
1942250857
Registry record updated Jun 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
022897 Issued in GA
Practice address
2064 Vineville Ave
Macon, GA 31204-3140
Phone
(478) 743-1478
Fax
(478) 746-8536
NPI assigned
May 11, 2006
Last updated
Jun 29, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 022897 GA Primary

Addresses

Primary practice location

2064 Vineville Ave
Macon, GA 31204-3140

Mailing address

2064 Vineville Ave
Macon, GA 31204-3140
Phone (478) 743-1478

Other identifiers 1

IdentifierTypeStateIssuer
00237212MedicaidGA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101103000141 GA Practitioner - Cardiovascular Disease (Cardiology) 2365346996 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Cardiology Associates PC Specialist CurrentSince Mar 17, 2015 Accepting new patients
Dublin-Macon Cardiology, PC Current Accepting new patients

Locations

206 Hospital Dr
Ste A
Dublin, GA 31021
Phone (478) 272-3525

2064 Vineville Ave
Macon, GA 31204
Phone (478) 272-3525

3330 Northside Dr
Ste 200
Macon, GA 31210
Phone (478) 309-1809

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277769600000",
    "number": "1942250857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2064 VINEVILLE AVE",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312043140",
            "telephone_number": "478-743-1478",
            "fax_number": "478-746-8536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2064 VINEVILLE AVE",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312043140",
            "telephone_number": "478-743-1478",
            "fax_number": "478-746-8536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERRY",
        "first_name": "THOMAS",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2010-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "022897",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00237212",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.