Terry Lee Gourley, PA - Medicare Physician Assistant in Ellsworth Afb, SD

Terry Lee Gourley, PA is a medicare enrolled "Physician Assistant - Medical" in Ellsworth Afb, South Dakota. His current practice location is 2900 Doolittle Dr, Ellsworth Afb, South Dakota. You can reach out to his office (for appointments etc.) via phone at (053) 853-2736.

Terry Lee Gourley is licensed to practice in Nebraska (license number 866) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1710014477.

Contact Information

Terry Lee Gourley, PA
2900 Doolittle Dr,
Ellsworth Afb, SD 57706-4821
(053) 853-2736
(308) 367-4164



Provider's Profile

Full NameTerry Lee Gourley
GenderMale
SpecialityPhysician Assistant - Medical
Location2900 Doolittle Dr, Ellsworth Afb, South Dakota
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1710014477
  • Provider Enumeration Date: 02/28/2007
  • Last Update Date: 05/03/2018
  Medicare PECOS Information:
  • PECOS PAC ID: 0244318574
  • Enrollment ID: I20130626000218

Medical Identifiers

Medical identifiers for Terry Lee Gourley such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1710014477NPI-NPPES
866OtherNELICENSE
1029358OtherSDNCCPA CERT

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363AM0700XPhysician Assistant - Medical 866 (Nebraska)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Terry Lee Gourley is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Terry Lee Gourley, PA
2900 Doolittle Dr,
Ellsworth Afb, SD 57706-4821

Ph: (605) 385-3111
Terry Lee Gourley, PA
2900 Doolittle Dr,
Ellsworth Afb, SD 57706-4821

Ph: (053) 853-2736

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Physician Assistant Nurses in Ellsworth Afb, SD

Audrey Mcreavy, PA-C
Physician Assistant
Medicare: Medicare Enrolled
Practice Location: 2900 Doolittle Dr, Ellsworth Afb, SD 57706
Phone: 605-385-3354    
Douglas Robert Ryan, PA-C
Physician Assistant
Medicare: Not Enrolled in Medicare
Practice Location: 2900 Doolittle Dr, Ellsworth Afb, SD 57706
Phone: 605-385-6700    
Blake T Greenfield, PA-C
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 2900 Doolittle Dr, Ellsworth Afb, SD 57706
Phone: 605-385-3111    
Kirsten Noel Anders, PA-C
Physician Assistant
Medicare: Not Enrolled in Medicare
Practice Location: 2900 Doolittle Dr, Ellsworth Afb, SD 57706
Phone: 605-385-3111    
Joshua R Paull, PA-C
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 2900 Doolittle Dr, Ellsworth Afb, SD 57706
Phone: 605-385-6700    
Jordan Hickman, PA-C
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 2900 Doolittle Dr, Ellsworth Afb, SD 57706
Phone: 605-675-1000    

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