NPIMap

Organization Active NPI

Etmc First Physicians Clinic

  • Family Nurse Practitioner
  • Tyler, TX
National Provider Identifier
1366743643
Registry record updated Nov 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
714451 Issued in TX
Legal business name
ETMC FIRST PHYSICIANS CLINIC
Practice address
700 Olympic Plaza Cir Ste 600
Tyler, TX 75701-1954
Phone
(903) 596-3844
NPI assigned
Nov 3, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2010

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

Authorized official

Name
Ms. Amber Allen
Title
Management Service Operation
Phone
(903) 596-3588

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 714451 TX Primary

Addresses

Primary practice location

700 Olympic Plaza Cir Ste 600
Tyler, TX 75701-1954

Mailing address

700 Olympic Plaza Cir Ste 600
Tyler, TX 75701-1954
Phone (903) 596-3844

National Provider Directory

National Provider Directory
Tax ID family
East Texas Medical Center Healthcare Associates4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1288742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288742400000",
    "number": "1366743643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 OLYMPIC PLAZA CIR STE 600",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757011954",
            "telephone_number": "903-596-3844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 OLYMPIC PLAZA CIR STE 600",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757011954",
            "telephone_number": "903-596-3844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ETMC FIRST PHYSICIANS CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-03",
        "last_updated": "2010-11-03",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "AMBER",
        "authorized_official_title_or_position": "MANAGEMENT SERVICE OPERATION",
        "authorized_official_telephone_number": "903-596-3588",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "714451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.