NPIMap

Individual provider Active NPI

Tad Wayland Titlow, APN-C

  • Family Nurse Practitioner
  • Henderson, TX
National Provider Identifier
1073725669
Registry record updated Oct 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
652143 Issued in TX
Practice address
105 North High Street
Henderson, TX 75652-3133
Phone
(903) 392-8259
Fax
(903) 392-8013
NPI assigned
May 4, 2007
Last updated
Oct 14, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 652143 TX Primary

Addresses

Primary practice location

105 North High Street
Henderson, TX 75652-3133

Mailing address

105 N High St
Henderson, TX 75652-3133
Phone (903) 392-8259

Other identifiers 1

IdentifierTypeStateIssuer
652143OtherTXLICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080606000235 TX Practitioner - Nurse Practitioner 0345310090 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Texas Tech University Health Science Center School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Henderson Family Medicine, PLLCGroup PAC ID 7113059155, 5 clinicians

Practice addresses (Care Compare)

105 N High St
Henderson Family Medicine
Henderson, TX 75652-3133
Phone (903) 392-8259

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
652143TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Henderson Family Medicine, PLLC CurrentSince Oct 24, 2010 Accepting new patients

Locations

105 N High St
Henderson, TX 75652
Phone (903) 392-8259

Interoperability endpoints

  • Direct secure messaging: tadtitlow@hfmp-tx.direct.office.nextgen.com
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 1

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 9

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": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287014400000",
    "number": "1073725669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 N HIGH ST",
            "city": "HENDERSON",
            "state": "TX",
            "postal_code": "756523133",
            "telephone_number": "903-392-8259",
            "fax_number": "903-392-8013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 NORTH HIGH STREET",
            "city": "HENDERSON",
            "state": "TX",
            "postal_code": "756523133",
            "telephone_number": "903-392-8259",
            "fax_number": "903-392-8013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TITLOW",
        "first_name": "TAD",
        "middle_name": "WAYLAND",
        "credential": "APN-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-04",
        "last_updated": "2010-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "652143",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "652143",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, TX

Sources for this page

Verify at the official NPI Registry.