NPIMap

Individual provider Active NPI

Katrina Y. Glover, M.D.

  • Hematology & Oncology Physician
  • Tyler, TX
National Provider Identifier
1144248501
Registry record updated Jul 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
M0091 Issued in TX
Practice address
721 Clinic Dr
Ste a
Tyler, TX 75701-2043
Phone
(903) 592-6152
Fax
(903) 592-5288
NPI assigned
Jul 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X M0091 TX Primary

Addresses

Primary practice location

721 Clinic Dr
Ste a
Tyler, TX 75701-2043

Mailing address

PO Box 731912
Dallas, TX 75373-1912
Phone (903) 877-7635

Other identifiers 3

IdentifierTypeStateIssuer
8F6320OtherBCBS
P00787093OtherTXRAILROAD MEDICARE
170559203MedicaidTX

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
I20041026000512 TX Practitioner - Hematology/OncologyPractitioner - Internal Medicine 6901867506 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/OncologyAlso: Internal Medicine
Education
University of Texas Southwestern Medical School at Dallas, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1000 S Beckham Ave
Ut Health Science Center at Tyler
Tyler, TX 75701-1908
Phone (903) 877-7200

102 W Henderson St
Ut Health Northeast Overton
Overton, TX 75684-1613
Phone (903) 834-0201

115 Medical Cir
Suite 106
Athens, TX 75751-9004
Phone (903) 284-5024

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
M0091TXMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Health Science Center at Tyler-Facilty-Physician CurrentSince Aug 1, 2019 Accepting new patients
University of Texas Health Science Center at Tyler-Facility-Physician CurrentSince Aug 1, 2019 Accepting new patients
Ut Physicians Past Accepting new patients
Ut Physicians Past Accepting new patients

Locations

115 Medical Cir
Ste 106
Athens, TX 75751
Phone (903) 284-5024

102 W Henderson St
Overton, TX 75684
Phone (903) 834-0201

721 Clinic Dr
#A
Tyler, TX 75701
Phone (903) 592-6152

Interoperability endpoints

  • Direct secure messaging: kglover355691@ahs.direct-ci.com

Organizations & group practices 4

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 5

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563408000000",
    "number": "1144248501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 731912",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753731912",
            "telephone_number": "903-877-7635",
            "fax_number": "903-877-7754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 CLINIC DR",
            "address_2": "STE A",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757012043",
            "telephone_number": "903-592-6152",
            "fax_number": "903-592-5288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLOVER",
        "first_name": "KATRINA",
        "middle_name": "Y.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2019-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "TX",
            "license": "M0091",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8F6320",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00787093",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "170559203",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.