Individual provider Active NPI

Tanya R Champa, BSN, MS, FNP

  • Family Nurse Practitioner
  • Forney, TX
National Provider Identifier
1285752444
Registry record updated Mar 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP128037 Issued in TX
Practice address
763 E US Highway 80 Ste 240
Forney, TX 75126-8677
Phone
(469) 800-3870
NPI assigned
Mar 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP128037 TX Primary

Addresses

Primary practice location

763 E US Highway 80 Ste 240
Forney, TX 75126-8677

Mailing address

724 Starlight Pass
Heath, TX 75032-5984
Phone (815) 439-8043

Other practice location 1

200 N Virginia St
Terrell, TX 75160-2732
Phone (469) 800-3100

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tchampa285859@direct.sw.org

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
I20150526002126 TX Practitioner - Nurse Practitioner 9335291871 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

821 N Coleman St
Suite 100
Prosper, TX 75078-2339
Phone (469) 800-5200

Hospital & facility affiliations

  • Baylor Scott and White Medical Center Lake Pointe Hospital, Rowlett, TX, CCN 450742

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor on Science - Nursing, Master of Science, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP128037TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network Current Accepting new patients
Healthtexas Provider Network CurrentSince May 16, 2019 Accepting new patients
Healthtexas Provider Network CurrentSince May 16, 2019 Accepting new patients

Locations

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

821 N Coleman St
Ste 100
Prosper, TX 75078
Phone (469) 800-5200

200 N Virginia St
Terrell, TX 75160
Phone 97255174007500

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 1

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": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648598400000",
    "number": "1285752444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "724 STARLIGHT PASS",
            "city": "HEATH",
            "state": "TX",
            "postal_code": "750325984",
            "telephone_number": "815-439-8043",
            "fax_number": "469-800-3110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "763 E US HIGHWAY 80 STE 240",
            "city": "FORNEY",
            "state": "TX",
            "postal_code": "751268677",
            "telephone_number": "469-800-3870"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 N Virginia St",
            "address_purpose": "LOCATION",
            "city": "Terrell",
            "state": "TX",
            "postal_code": "751602732",
            "country_code": "US",
            "telephone_number": "469-800-3100",
            "fax_number": "469-800-3110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAMPA",
        "first_name": "TANYA",
        "middle_name": "R",
        "credential": "BSN, MS, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-27",
        "last_updated": "2022-03-30",
        "certification_date": "2022-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP128037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tchampa285859@direct.sw.org",
            "affiliation": "N",
            "address_1": "200 N Virginia St",
            "city": "Terrell",
            "state": "TX",
            "country_code": "US",
            "postal_code": "751602732",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Forney, TX

Sources for this page

Verify at the official NPI Registry.