Individual provider Active NPI

Tara Welch, RN

  • Certified Registered Nurse Anesthetist
  • Tyler, TX
National Provider Identifier
1467178459
Registry record updated Jun 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1101443 Issued in TX
Practice address
1000 S Beckham Ave
Tyler, TX 75701-1908
Phone
(903) 597-0351
NPI assigned
Oct 12, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X 669039 TX
Certified Registered Nurse Anesthetist 367500000X 1101443 TX Primary

Addresses

Primary practice location

1000 S Beckham Ave
Tyler, TX 75701-1908

Mailing address

7005 Walden Dr
Tyler, TX 75703-0917
Phone (903) 343-3369

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230605001574 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 0244292506 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Endo Sedation LLCGroup PAC ID 4789845363, 289 clinicians

Practice addresses (Care Compare)

3500 Preston Rd
Suite 200
Plano, TX 75093-8644
Phone (972) 985-2300

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
669039TXMDCritical Care Medicine Registered Nurse
1101443TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Endo Sedation LLC Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2024 Accepting new patients
Northstar Anesthesia III PA Nurse Anesthetist, Certified Registered CurrentSince Feb 21, 2023 Accepting new patients
Endo Sedation LLC Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2024 Accepting new patients

Locations

981 State Highway 121
Ste 2100
Allen, TX 75013
Phone (214) 383-8210

3315 S Alameda St
Corpus Christi, TX 78411
Phone (361) 761-1400

1001 Surrey Ln
Flower Mound, TX 75022
Phone (817) 337-3671

1400 8th Ave
Ft Worth, TX 76104
Phone (817) 922-1559

180 Bear Creek Pkwy
Keller, TX 76248
Phone (817) 337-3671

2704 N Galloway Ave
Ste 102
Mesquite, TX 75150
Phone (972) 961-7171

3500 Preston Rd
Ste 200
Plano, TX 75093
Phone (972) 985-2300

11937 US Highway 271
Tyler, TX 75708
Phone (903) 877-3451

1000 S Beckham Ave
Tyler, TX 75701
Phone (903) 526-1068

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.

NPI Registry JSON

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

{
    "created_epoch": "1665532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687132800000",
    "number": "1467178459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7005 WALDEN DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757030917",
            "telephone_number": "903-343-3369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 S BECKHAM AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757011908",
            "telephone_number": "903-597-0351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELCH",
        "first_name": "TARA",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-12",
        "last_updated": "2023-06-19",
        "certification_date": "2023-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "TX",
            "license": "669039",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "1101443",
            "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 Jun 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.