Individual provider Active NPI

Tara Marie McElroy, NP-C

  • Family Nurse Practitioner
  • Texarkana, TX
National Provider Identifier
1134415417
Registry record updated May 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP120533 Issued in TX
Practice address
5420 Medical Parkway Dr
Texarkana, TX 75503-4622
Phone
(903) 223-5931
Fax
(903) 223-5930
NPI assigned
Jun 24, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X A03679 AR
Family Nurse Practitioner 363LF0000X AP120533 TX Primary
Family Nurse Practitioner 363LF0000X 800130 TX

Addresses

Primary practice location

5420 Medical Parkway Dr
Texarkana, TX 75503-4622

Mailing address

5420 Medical Parkway Dr
Texarkana, TX 75503-4622
Phone (903) 223-5931

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
I20110926000219 TX Practitioner - Nurse Practitioner 3870764715 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5483 Summerhill Rd
Texarkana, TX 75503-4608
Phone (903) 223-5931

Hospital & facility affiliations

  • Christus St Michael Health System Hospital, Texarkana, TX, CCN 450801

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A03679ARMDFamily Nurse Practitioner
800130TXMDFamily Nurse Practitioner
AP120533TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Twin City Medical CurrentSince Jan 17, 2022 Accepting new patients

Locations

5483 Summerhill Rd
Texarkana, TX 75503
Phone (903) 223-5931

5420 Medical Parkway Dr
Texarkana, TX 75503
Phone (903) 793-8966

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1308873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746576000000",
    "number": "1134415417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5420 MEDICAL PARKWAY DR",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755034622",
            "telephone_number": "903-223-5931",
            "fax_number": "903-223-5930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5420 MEDICAL PARKWAY DR",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755034622",
            "telephone_number": "903-223-5931",
            "fax_number": "903-223-5930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCELROY",
        "first_name": "TARA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-24",
        "last_updated": "2025-05-07",
        "certification_date": "2025-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A03679",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP120533",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "800130",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Texarkana, TX

Sources for this page

Verify at the official NPI Registry.