NPIMap

Individual provider Active NPI

Terry L Hallwachs, PA

  • Physician Assistant
  • Oak Ridge, TN
National Provider Identifier
1962448860
Registry record updated Jul 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1571 Issued in TN
Practice address
988 Oak Ridge Tpke
Suite 100
Oak Ridge, TN 37830-6930
Phone
(865) 483-8478
Fax
(865) 483-4194
NPI assigned
Jun 21, 2006
Last updated
Jul 27, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 3957 GA
Medical Physician Assistant 363AM0700X 1571 TN
Physician Assistant 363A00000X 1571 TN Primary

Addresses

Primary practice location

988 Oak Ridge Tpke
Suite 100
Oak Ridge, TN 37830-6930

Mailing address

308 N Peters Rd
Suite 225
Knoxville, TN 37922-2356
Phone (865) 694-7725

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, WY2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20080207000340 TN Practitioner - Physician Assistant 6103899885 Reassigns benefits to 1 organization
I20201022000221 WY Practitioner - Physician Assistant 6103899885 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Lincoln Hospital DistrictGroup PAC ID 2961490057, 11 clinicians

Practice addresses (Care Compare)

1105 Cedar Ave
Kemmerer, WY 83101-3231

711 Onyx St
Kemmerer, WY 83101-3214
Phone 30787744013115

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
3957GAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Campbell County Hospital District, CurrentSince Nov 2, 2020 Accepting new patients
South Lincoln Hospital District CurrentSince Apr 1, 2025 Accepting new patients
Campbell County Hospital District Current Accepting new patients
South Lincoln Hospital District CurrentSince Apr 1, 2025 Accepting new patients
Campbell County Hospital District CurrentSince Nov 2, 2020 Accepting new patients
South Lincoln Hospital District Past Accepting new patients
South Lincoln Hospital District Past Accepting new patients
South Lincoln Hospital District Past Accepting new patients
Sterling Emergency Services of the Southeast Inc Medical Past Accepting new patients

Locations

501 S Burma Ave
Gillette, WY 82716
Phone (307) 682-8811

501 S Burma Ave
Fl 3
Gillette, WY 82716
Phone (307) 688-3636

711 Onyx St
Kemmerer, WY 83101
Phone (307) 877-4401

Interoperability endpoints

  • Direct secure messaging: terry.hallwachs.1@16971.direct.athenahealth.com

Organizations & group practices 12

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.

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": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501113600000",
    "number": "1962448860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 N PETERS RD",
            "address_2": "SUITE 225",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379222356",
            "telephone_number": "865-694-7725",
            "fax_number": "865-483-4194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "988 OAK RIDGE TPKE",
            "address_2": "SUITE 100",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378306930",
            "telephone_number": "865-483-8478",
            "fax_number": "865-483-4194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALLWACHS",
        "first_name": "TERRY",
        "middle_name": "L",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-21",
        "last_updated": "2017-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "3957",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TN",
            "license": "1571",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "1571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Ridge, TN

Sources for this page

Verify at the official NPI Registry.