Active NPI
Stephanie Renee Tyo, MD
- Family Medicine Physician
- Tyler, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 30198
- Practice address
- 13172 State Highway 64 E
Tyler, TX 75707-5340 - Phone
- (903) 535-9041
- Fax
- (903) 630-6740
- NPI assigned
- Jun 2, 2010
- Last updated
- Jan 5, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 30198 | WV | Primary |
Addresses
Primary practice location
13172 State Highway 64 E
Tyler, TX 75707-5340
Mailing address
523 S Fannin Ave
Tyler, TX 75702-8204
Phone (903) 535-9041
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX, WV
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- West Virginia University School of Medicine, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
13172 State Hwy 64 E
Tyler, TX 75707-5340
Phone (903) 606-2212
Merit-based Incentive Payment System (MIPS)
- Final score
- 90.94 of 100
- Quality
- 69.71
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30198 | WV | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cabin Creek Health Center, Inc. | Current | Accepting new patients | |
| Cabin Creek Health Center, Inc. | Current | Accepting new patients | |
| Goodside Health Medical, PLLC | Past | Accepting new patients | |
| Tyler Family Circle of Care | Past | Accepting new patients |
Locations
1 Warrior Way
Ste 103
Belle, WV 25015
Phone (304) 949-3591
104 Alex Ln
Charleston, WV 25304
Phone 30473420401319
107 Koontz Ave
Ste 200
Clendenin, WV 25045
Phone (304) 548-7272
Interoperability endpoints
- stephanie.tyo.1@7267.direct.athenahealth.com
- styo584372@christushealth.direct-ci.net
Organizations & group practices 5
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.
-
dba Family Circle of Care
- Federally Qualified Health Center (FQHC)
- Tyler, TX
- NPI 1144575820
-
- Federally Qualified Health Center (FQHC)
- Dawes, WV
- NPI 1366495525
-
dba Westside Health Center
- Federally Qualified Health Center (FQHC)
- Charleston, WV
- NPI 1194596759
-
dba Family Circle of Care
- Community/Retail Pharmacy
- Tyler, TX
- NPI 1942011903
-
- Pediatrics Physician
- Albuquerque, NM
- NPI 1033972716
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1275436800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1767571200000",
"number": "1417277435",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "523 S FANNIN AVE",
"city": "TYLER",
"state": "TX",
"postal_code": "757028204",
"telephone_number": "903-535-9041",
"fax_number": "903-630-2039"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13172 STATE HIGHWAY 64 E",
"city": "TYLER",
"state": "TX",
"postal_code": "757075340",
"telephone_number": "903-535-9041",
"fax_number": "903-630-6740"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TYO",
"first_name": "STEPHANIE",
"middle_name": "RENEE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-06-02",
"last_updated": "2026-01-05",
"certification_date": "2026-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WV",
"license": "30198",
"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 Jan 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.