Individual provider Active NPI

Sara Lee Maxey, CNP

  • Family Nurse Practitioner
  • Tyler, TX
National Provider Identifier
1497473243
Registry record updated Feb 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1049937 Issued in TX
Practice address
700 Olympic Plaza Cir Ste 420
Tyler, TX 75701-1952
Phone
(903) 531-8950
Fax
(903) 531-8964
NPI assigned
Aug 18, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 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 1049937 TX Primary

Addresses

Primary practice location

700 Olympic Plaza Cir Ste 420
Tyler, TX 75701-1952

Mailing address

700 Olympic Plaza Cir Ste 420
Tyler, TX 75701-1952
Phone (903) 531-8950

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
I20221220002216 TX Practitioner - Nurse Practitioner 1153790845 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Etmc Physician Group, Inc.Group PAC ID 4486915600, 375 clinicians

Practice addresses (Care Compare)

18118 FM 344
Flint, TX 75762-6010
Phone (903) 825-3292

2114 E Rusk St
Jacksonville, TX 75766-9052
Phone (903) 531-8950

2116 E Rusk St
Jacksonville, TX 75766-9052
Phone (903) 592-6901

700 Olympic Plaza Cir
Tyler, TX 75701-1952

Hospital & facility affiliations

  • Ut Health East Texas Tyler Regional Hospital Hospital, Tyler, TX, CCN 450083
  • Ut Health East Texas Jacksonville Hospital Hospital, Jacksonville, TX, CCN 450194
  • University of Texas Health Science Center at Tyler Hospital, Tyler, TX, CCN 450690
  • Christus Mother Frances Hospital Hospital, Tyler, TX, CCN 450102

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1049937TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Etmc Physician Group Inc. CurrentSince Dec 1, 2022 Accepting new patients
Etmc Physician Group Inc. CurrentSince Dec 1, 2022 Accepting new patients
Starks Medical Past Accepting new patients

Locations

18118 FM 344 W
Flint, TX 75762
Phone (903) 825-3292

2114 E Rusk St
Jacksonville, TX 75766
Phone (903) 284-6105

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

700 Olympic Plaza Cir
Ste 420
Tyler, TX 75701
Phone (903) 526-2500

700 Olympic Plaza Cir
Ste 410
Tyler, TX 75701
Phone (903) 531-8950

Interoperability endpoints

  • Direct secure messaging: smaxey836563@ahs.direct-ci.com

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1660780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675814400000",
    "number": "1497473243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 OLYMPIC PLAZA CIR STE 420",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757011952",
            "telephone_number": "903-531-8950",
            "fax_number": "903-531-8964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 OLYMPIC PLAZA CIR STE 420",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757011952",
            "telephone_number": "903-531-8950",
            "fax_number": "903-531-8964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAXEY",
        "first_name": "SARA",
        "middle_name": "LEE",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-18",
        "last_updated": "2023-02-08",
        "certification_date": "2023-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1049937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.