Mary Angela McInnis, DNP, APRN, ENP, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

671796 Issued in TX

Practice address

1303 Elk River Rd
Tyler, TX 75703-7456

Phone

(713) 397-9773

NPI assigned

Mar 11, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Acs Primary Care Physicians Southwest, PA

  • Emergency Medicine Physician
  • Gainesville, TX
  • NPI 1538101019

  Nurse Practitioner

  Medicare reassignment NPD
• Family First Urgent Care PLLC

  • Urgent Care Clinic/Center
  • Jacksonville, TX
  • NPI 1639506876
  Medicare reassignment NPD
• University of Texas Health Science Center at Tyler-Facility-Physician

  • Sports Medicine (Neuromusculoskeletal Medicine) Physician
  • Tyler, TX
  • NPI 1063400778
  Medicare reassignment NPD
• University of Texas Health Science Center at Tyler-Facilty-Physician

  • Rural Health Clinic/Center
  • Overton, TX
  • NPI 1689496812
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1205193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492387200000",
    "number": "1134399751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1303 ELK RIVER RD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757037456",
            "telephone_number": "713-397-9773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1303 ELK RIVER RD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757037456",
            "telephone_number": "713-397-9773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINNIS",
        "first_name": "MARY",
        "middle_name": "ANGELA",
        "credential": "DNP, APRN, ENP, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-11",
        "last_updated": "2017-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "671796",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "671796",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "671796",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thomas Michael McGovern, MD
• Tiara Chante McGowen, NP
• Glynna Tarrant McGuffey, PT, DPT
• Lindsey McGuire, PTA
• Chance Michael McInnis
• David Douglas McIntire, R.PH.
• David Clay McIntyre, AGNP-C
• Jennifer Marie McKelva, PA-C
• Michael McKelva
• Jennifer May McKenzie, RN

• Nurse Practitioner in Tyler, TX
• Providers in Tyler, TX by specialty
• Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.