Mary Dutchover, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP125894 Issued in TX

Practice address

910 James Bowie Dr
New Boston, TX 75570-2335

Phone

(903) 614-5950

Fax

(903) 614-5950

NPI assigned

Aug 5, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Christus Trinity Clinic TexasGroup PAC ID 3072426741, 1,540 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Enhabit Home Health Home health agency, Longview, TX, CCN 679079
• Christus Homecare - St Michael Home health agency, Texarkana, TX, CCN 679372
• Christus St Michael Health System Hospital, Texarkana, TX, CCN 450801

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/996/brand/1/csg/213/fhir/r4
• Direct secure messaging: mdutchover226144@christushealth.direct-ci.net

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.

• Christus Trinity Clinic Texas

  • Family Medicine Physician
  • Tyler, TX
  • NPI 1285684225
  Medicare reassignment Care Compare group NPD
• C H Wilkinson Physician Network

  • Family Medicine Physician
  • Irving, TX
  • NPI 1457382947
  Medicare reassignment NPD
• C H Wilkinson Physician Network

  • Orthopaedic Surgery Physician
  • Corpus Christi, TX
  • NPI 1750826095
  NPD
• Christus Trinity Clinic Texas

  • Rural Health Clinic/Center
  • Winnsboro, TX
  • NPI 1801673165
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ahm Action Home Health, LP

  • Home Health Agency
  • Longview, TX
  • NPI 1609934470
  Care Compare affiliation
• Christus Health Ark-la-Tex

  • General Practice Physician
  • Texarkana, TX
  • NPI 1184623266

  Hospital

  Care Compare affiliation
• Christus Health Ark-la-Tex

  • General Acute Care Hospital
  • Texarkana, TX
  • NPI 1295736734
  Care Compare affiliation
• Texas Health Care Group of Texarkana, LLC

  • Home Health Agency
  • Texarkana, TX
  • NPI 1437269651
  Care Compare affiliation

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

{
    "created_epoch": "1407196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1154730166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "919 HIDDEN RDG",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750383813",
            "telephone_number": "469-282-2711",
            "fax_number": "469-282-2609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 JAMES BOWIE DR",
            "city": "NEW BOSTON",
            "state": "TX",
            "postal_code": "755702335",
            "telephone_number": "903-614-5950",
            "fax_number": "903-614-5950"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3502 Richmond Rd",
            "address_purpose": "LOCATION",
            "city": "Texarkana",
            "state": "TX",
            "postal_code": "755030705",
            "country_code": "US",
            "telephone_number": "903-614-5270",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "700 Davey Crockett Dr Ste 500",
            "address_purpose": "LOCATION",
            "city": "New Boston",
            "state": "TX",
            "postal_code": "755702336",
            "country_code": "US",
            "telephone_number": "903-614-5950",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUTCHOVER",
        "first_name": "MARY",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-05",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP125894",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200616050A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "350226201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brent Danley
• Dawn Renee' Davis
• George Ashu Deba
• Debra K Reid
• Larrice Michelle Dunn
• Casey E Easley, PHARMD
• Robert Gerald Edgin, RPH
• Danny K Elkins, RPH
• Faith Isabella Ellis, CD(DONA)
• Bobby Royce English, DC

• Family Nurse Practitioner in New Boston, TX
• Providers in New Boston, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.