KEVIN TERRELL (NPI# 1760591648) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760591648 |
| Entity Type | Individual |
| Full Name | KEVIN TERRELL |
| Credential | MD |
| Practice Address |
2630 22nd St Columbus IN 47201 |
| Mailing Address |
Po Box 775383 Chicago IL 60677-5383 |
| Practice Telephone | 8123753784 |
| Practice Fax Number | 8123753781 |
| Mailing Telephone | 8123753000 |
| Mailing Fax Number | 8123753477 |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2020-11-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | 02001985A | IN | Allopathic & Osteopathic Physicians |
| Y | 207QA0401X |
Family Medicine Specialization: Addiction Medicine |
02001985A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200215910 | 05 | |
| IN | ANTHEM | 000000112255 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1001 W 10th St, Indianapolis, IN 462022859 | 3176307276 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891724464 | Kevin Boyd Terrell | Dentist | 4616 W Lovers Ln, #212, Dallas, TX 75209-3101 | 2006-07-03 |
| Street Address |
2630 22ND ST |
| City | COLUMBUS |
| State | IN |
| Zip Code | 47201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457332413 | Southeastern Indiana Gastroenterology | Specialist | 2630 22nd St, Columbus, IN 47201-3702 | 2005-11-08 |
| 1245874296 | Amber Rose James | Nurse Practitioner | 2630 22nd St, Columbus, IN 47201-3702 | 2019-11-03 |
| 1982265146 | Sharen Marie Waters | Counselor | 2630 22nd St, Columbus, IN 47201-3702 | 2019-06-27 |
| 1861628661 | Patrick Barrett | Internal Medicine | 2630 22nd St, Columbus, IN 47201-3702 | 2009-06-08 |
| 1427094192 | Geoffrey S Raymer | Internal Medicine | 2630 22nd St, Columbus, IN 47201-3702 | 2006-06-21 |
| 1700853942 | Lora Fathauer | Internal Medicine | 2630 22nd St, Columbus, IN 47201-3702 | 2006-03-07 |
| 1508830373 | Stephen R Stouder | Internal Medicine | 2630 22nd St, Columbus, IN 47201-3702 | 2006-02-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699389569 | Ryanne Nicole Slavens | Speech-Language Pathologist | 1974 Glenmoor Drive, Columbus, IN 47201 | 2020-09-08 |
| 1023670759 | Alisha Nicole Scoville | Counselor | 2630 22nd Street, Columbus, IN 47201 | 2019-07-02 |
| 1467964718 | Columbus Radiology Physicians LLC | Radiology | 2400 E. 17th Street, Columbus, IN 47201 | 2017-10-26 |
| 1790148849 | Gabriel Woon | Specialist | 913 25th St., Columbus, IN 47201 | 2016-04-05 |
| 1144680604 | Forefront Dermatology, S.c. | Dermatology | 244 Westwood Blvd, Columbus, IN 47201 | 2016-02-26 |
| 1871832550 | Jennifer Lynn Grant | Nurse Practitioner | 836 Jackson St., Columbus, IN 47201 | 2013-01-31 |
| 1235404526 | Eric Philip Tannenbaum | Orthopaedic Surgery | 940 N Marr Rd Ste C, Columbus, IN 47201 | 2012-03-20 |
| 1881994176 | Terri Ann Brewer | Social Worker | 12000 W. Moores Vineyard Rd, Columbus, IN 47201 | 2010-11-02 |
| 1255654620 | The Kane Group LLC | Durable Medical Equipment & Medical Supplies | 927 Fourth Street, Columbus, IN 47201 | 2010-03-12 |
| 1023243771 | Allison K Royer | Otolaryngology | 2326 18th Street, Suite 230, Columbus, IN 47201 | 2009-05-26 |
| Find all providers in zip 47201 | ||||
| Taxonomy Code | 207QA0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Addiction Medicine |
| A family medicine physician who specializes in the diagnosis and treatment of addictions. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) was, but is no longer issued by the American Osteopathic Board of Family Physicians. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124535828 | Ats, Columbus, LLC Dba, Addiction Therapy Services | Family Medicine | 4760 Sawmill Rd, Columbus, OH 43235-3260 | 2018-01-03 |
| 1245755990 | Pathway Healthcare- Columbus, Ms LLC | Family Medicine | 3600 Bluecutt Rd Ste 200, Columbus, MS 39705-1303 | 2017-08-03 |
| 1598071334 | Medsave Healthcare Clinics Inc | Family Medicine | 246 E Campus View Blvd, Columbus, OH 43235 | 2010-08-30 |
| 1700056033 | Latonya Janett Carroll | Family Medicine | 655 N Cassady Ave Ste 7, Columbus, OH 43219-2720 | 2008-03-03 |
| 1942484167 | Medical and Natural Nutritional Alternatives Inc | Family Medicine | 730 Mount Airyshire Blvd A, Columbus, OH 43235-1328 | 2007-12-24 |
| 1366655656 | Roger Garcia | Family Medicine | 4889 Sinclair Rd Ste 112, Columbus, OH 43229-5433 | 2007-05-07 |
| 1144275181 | Larry S Everhart | Family Medicine | 730 Mount Airyshire Blvd, A, Columbus, OH 43235-1328 | 2006-05-24 |
| 1447884077 | First Care Integrated Health LLC | Family Medicine | 5150 E Main St Ste 105, Columbus, OH 43213-2441 | 2020-02-21 |
| 1649733445 | Ohio Addiction Management | Family Medicine | 2525 Oakstone Dr Ste B, Columbus, OH 43231-8626 | 2019-04-09 |
| 1790279131 | Ohio Addiction Management, LLC | Family Medicine | 5460 Cleveland Ave, Columbus, OH 43231-4005 | 2018-06-19 |
| Find all providers in COLUMBUS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.