Individual provider Active NPI

Tina Katherine Sturgeon, NP

  • Family Nurse Practitioner
  • Palestine, TX
National Provider Identifier
1407322472
Registry record updated Jan 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP139957 Issued in TX
Practice address
111 Medical Dr
Palestine, TX 75801-4781
Phone
(903) 723-6092
NPI assigned
Oct 17, 2018
Last updated
Jan 25, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2023

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 AP139957 TX Primary

Addresses

Primary practice location

111 Medical Dr
Palestine, TX 75801-4781

Mailing address

111 Medical Dr
Palestine, TX 75801-4781
Phone (903) 723-6092

Other identifiers 1

IdentifierTypeStateIssuer
1407322472MedicaidTX

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
I20190603001336 TX Practitioner - Nurse Practitioner 6103159397 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DCS Medical PAGroup PAC ID 0042507600, 155 clinicians

Practice addresses (Care Compare)

1960 S Loop
256 Suite 100
Palestine, TX 75801
Phone (903) 212-1839

3201 University Dr E
135 Integrity Urgent Care
Bryan, TX 77802-3481
Phone (979) 703-1832

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP139957TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
DCS Medical PA CurrentSince Sep 9, 2024 Accepting new patients
DCS Medical PA CurrentSince Sep 9, 2024 Accepting new patients
DCS Medical PA Past Accepting new patients
DCS Medical PA Past Accepting new patients

Locations

3201 University Dr E
Ste 135
Bryan, TX 77802
Phone (979) 703-1832

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1539734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674604800000",
    "number": "1407322472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 MEDICAL DR",
            "city": "PALESTINE",
            "state": "TX",
            "postal_code": "758014781",
            "telephone_number": "903-723-6092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 MEDICAL DR",
            "city": "PALESTINE",
            "state": "TX",
            "postal_code": "758014781",
            "telephone_number": "903-723-6092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STURGEON",
        "first_name": "TINA",
        "middle_name": "KATHERINE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-17",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP139957",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1407322472",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palestine, TX

Sources for this page

Verify at the official NPI Registry.