Individual provider Active NPI

Tiffany Nicole Crenshaw, FNP-C

  • Nurse Practitioner
  • Sulphur Springs, TX
National Provider Identifier
1194458877
Registry record updated Jul 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1087041 Issued in TX
Practice address
1339 S Broadway St
Sulphur Springs, TX 75482-4895
Phone
(903) 951-1001
NPI assigned
Jul 8, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1087041 TX Primary
Family Nurse Practitioner 363LF0000X 1087041 TX

Addresses

Primary practice location

1339 S Broadway St
Sulphur Springs, TX 75482-4895

Mailing address

965 County Road 1040
Cooper, TX 75432-8519
Phone (940) 768-9839

Other practice location 1

3593 E Grande Blvd
Tyler, TX 75707-1400
Phone (903) 839-2585

Other practice location 2

5414 S Broadway Ave
Tyler, TX 75703-1335
Phone (903) 581-1601

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
I20220825004334 TX Practitioner - Nurse Practitioner 6103200019 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christus Trinity Clinic TexasGroup PAC ID 3072426741, 1,540 clinicians

Practice addresses (Care Compare)

1339 S Broadway St
Sulphur Springs, TX 75482-4895
Phone (903) 951-1000

620 S Fleishel Ave
Christus Trinity Clinic
Tyler, TX 75701-2041
Phone (903) 606-4900

630 S Fleishel Ave
Tyler, TX 75701-2041
Phone (903) 606-5560

PO Box
Suite 846098
Dallas, TX 75284-6098

Hospital & facility affiliations

  • Christus Mother Frances Hospital Hospital, Tyler, TX, CCN 450102
  • Christus Mother Frances Hospital Sulphur Springs Hospital, Sulphur Springs, TX, CCN 450236

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1087041TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mother Frances Hospital Regional Health Care Center CurrentSince Sep 26, 2022 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Sep 26, 2022 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Sep 26, 2022 Accepting new patients

Locations

1339 S Broadway St
Sulphur Springs, TX 75482
Phone (903) 951-1000

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

5414 S Broadway Ave
Tyler, TX 75703
Phone (903) 581-1601

800 E Dawson St
Tyler, TX 75701
Phone (903) 531-5018

3593 E Grande Blvd
Tyler, TX 75707
Phone (903) 606-1664

Interoperability endpoints

  • Direct secure messaging: tcrenshaw146856@christushealth.direct-ci.net

Organizations & group practices 3

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": "1657238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719878400000",
    "number": "1194458877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "965 COUNTY ROAD 1040",
            "city": "COOPER",
            "state": "TX",
            "postal_code": "754328519",
            "telephone_number": "940-768-9839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1339 S BROADWAY ST",
            "city": "SULPHUR SPRINGS",
            "state": "TX",
            "postal_code": "754824895",
            "telephone_number": "903-951-1001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3593 E Grande Blvd",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757071400",
            "country_code": "US",
            "telephone_number": "903-839-2585",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5414 S Broadway Ave",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757031335",
            "country_code": "US",
            "telephone_number": "903-581-1601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRENSHAW",
        "first_name": "TIFFANY",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-08",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1087041",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1087041",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sulphur Springs, TX

Sources for this page

Verify at the official NPI Registry.