Active NPI
Stephen M Tankersley, MD
- Psychiatry Physician
- Dallas, TX
National Provider Identifier
1174628564
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- G0188
- Practice address
- 3500 Oak Lawn
Suite 370
Dallas, TX 75219-4308 - Phone
- (214) 528-9240
- Fax
- (214) 559-0803
- NPI assigned
- Sep 13, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | G0188 | TX | Primary |
Addresses
Primary practice location
3500 Oak Lawn
Suite 370
Dallas, TX 75219-4308
Mailing address
3500 Oak Lawn
Suite 370
Dallas, TX 75219-4308
Phone (214) 528-9240
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00GH13 | Other | TX | MEDICARE SUBMITTER ID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G0188 | TX | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158105600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585699200000",
"number": "1174628564",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3500 OAK LAWN",
"address_2": "SUITE 370",
"city": "DALLAS",
"state": "TX",
"postal_code": "752194308",
"telephone_number": "214-528-9240",
"fax_number": "214-559-0803"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3500 OAK LAWN",
"address_2": "SUITE 370",
"city": "DALLAS",
"state": "TX",
"postal_code": "752194308",
"telephone_number": "214-528-9240",
"fax_number": "214-559-0803"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TANKERSLEY",
"first_name": "STEPHEN",
"middle_name": "M",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-13",
"last_updated": "2020-04-01",
"certification_date": "2020-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "TX",
"license": "G0188",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE SUBMITTER ID",
"identifier": "00GH13",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.