Individual provider Active NPI

Tamara Deniece Killough, FNP

  • Family Nurse Practitioner
  • Winters, TX
National Provider Identifier
1083017511
Registry record updated Mar 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP126526 Issued in TX
Practice address
7571 State Highway 153
Winters, TX 79567-7439
Phone
(325) 754-1317
Fax
(325) 754-1208
NPI assigned
Sep 29, 2014
Last updated
Mar 3, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2020

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 AP126526 TX Primary

Addresses

Primary practice location

7571 State Highway 153
Winters, TX 79567-7439

Mailing address

7571 State Highway 153
Winters, TX 79567-7439
Phone (325) 754-1317

Other names 1

  • Tamara Deniece Halfmann Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150722003709 TX Practitioner - Nurse Practitioner 1557674470 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Runnels County Hospital CurrentSince May 18, 2015 Accepting new patients
North Runnels County Hospital CurrentSince May 18, 2015 Accepting new patients
Acs Primary Care Physicians Southwest, PA Family CurrentSince May 1, 2026 Accepting new patients

Locations

7571 State Highway 153
Winters, TX 79567
Phone (325) 754-1317

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/northru-237b4f81

Organizations & group practices 3

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": "1411948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583193600000",
    "number": "1083017511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7571 STATE HIGHWAY 153",
            "city": "WINTERS",
            "state": "TX",
            "postal_code": "795677439",
            "telephone_number": "325-754-1317",
            "fax_number": "325-754-1208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7571 STATE HIGHWAY 153",
            "city": "WINTERS",
            "state": "TX",
            "postal_code": "795677439",
            "telephone_number": "325-754-1317",
            "fax_number": "325-754-1208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILLOUGH",
        "first_name": "TAMARA",
        "middle_name": "DENIECE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-29",
        "last_updated": "2020-03-03",
        "certification_date": "2020-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP126526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAMARA",
            "last_name": "HALFMANN",
            "middle_name": "DENIECE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Winters, TX

Sources for this page

Verify at the official NPI Registry.