Tiffany N Bynum
Individual provider Active NPI Family Nurse Practitioner · Midland, TX
NPI 1376006403 · NPPES record last updated Nov 15, 2024
Key facts
- NPI
- 1376006403
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 1002612 (TX)
- Practice address
- 4705 Briarwood Avenue
Midland, TX 79707-2639 - Phone
- (432) 505-4145
- Fax
- (833) 941-0864
- NPI assigned
- Apr 6, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Urgent Care Providers PLLC
Wes Tex Urgent Care PLLC
Practice addresses (Care Compare)
4705 Briarwood Ave
Midland, TX 79707-2639
Phone (432) 505-4145
6950 Eastridge Rd
Odessa, TX 79765-8971
Phone (432) 366-0207
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200921000308 | TX | Practitioner - Nurse Practitioner | 6608294848 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 785152 | TX | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wes Tex Urgent Care PLLC | Current | Accepting new patients | |
| Wes Tex Urgent Care, PLLC | Current |
Accepting new patients | |
| Wes Tex Urgent Care, PLLC | Current |
Accepting new patients | |
| Wes Tex Urgent Care, PLLC | Past | Accepting new patients | |
| MCH Professional Care | Past |
Accepting new patients |
Locations
616 N Main St
Andrews, TX 79714
Phone (432) 375-5247
4705 Briarwood Ave
Midland, TX 79707
Phone (432) 505-4145
6301 Andrews Hwy
Midland, TX 79706
Phone (432) 375-5247
210 W Longview Ave
Ste A
Midland, TX 79701
Phone (432) 789-1587
3490 E Yukon Rd
Odessa, TX 79762
Phone (432) 375-5247
6950 Eastridge Rd
Odessa, TX 79765
Phone (432) 366-0207
Interoperability endpoints
- tiffanybynum@rebeccajamesmd.directglo.com
- tiffany.bynum.1@26958.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 785152 | TX | |
| Family Nurse Practitioner | 363LF0000X | 1002612 | TX | Yes |
Addresses
Primary practice location
4705 Briarwood Avenue
Midland, TX 79707-2639
Mailing address
4705 Briarwood Avenue
Midland, TX 79707-2639
Phone (432) 505-4145
Other practice location 1
3490 East Yukon Rd
Odessa, TX 79762-2010
Phone (432) 520-4086
Other practice location 2
6950 Eastridge Road
Odessa, TX 79765-6209
Phone (432) 505-4145
Other practice location 3
6301 Andrews Hwy
Midland, TX 79706-3147
Phone (432) 505-4147 ext. 83344
Other practice location 4
616 N Main Street
Andrews, TX 79714-5207
Phone (432) 505-4146
Other providers in Midland, TX
- Lewis Busbee
- Yvette R Bustamante
- Abigail Marie Buterbaugh
- Rachael Marie Butler
- Bym Medical Supplies & Services LLC
- C Vallie CFNP Limited Partnership
- Diane Margret Balen Cabuguason
- Rebecca Ellyse Caffey
- Rebecca C Cagle
- Michael Thomas Caglia
All providers in Midland, TX · Family Nurse Practitioner in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 15, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.