Individual provider Active NPI

Tiara Chante McGowen, NP

  • Family Nurse Practitioner
  • Tyler, TX
National Provider Identifier
1578286266
Registry record updated Sep 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1073951 Issued in TX
Practice address
12675 County Road 463
Tyler, TX 75706-4206
Phone
(903) 630-0774
NPI assigned
Sep 19, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2022

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 1073951 TX Primary

Addresses

Primary practice location

12675 County Road 463
Tyler, TX 75706-4206

Mailing address

12675 County Road 463
Tyler, TX 75706-4206

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
I20240306004056 TX Practitioner - Nurse Practitioner 1153767660 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Phynet, Inc.Group PAC ID 8527038298, 15 clinicians

Practice addresses (Care Compare)

103 N Main St
Lindale, TX 75771-6417
Phone (903) 882-3194

Hospital & facility affiliations

  • Christus Mother Frances Hospital Hospital, Tyler, TX, CCN 450102

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Phynet, Inc. CurrentSince Feb 21, 2024 Accepting new patients
Phynet, Inc. Past Accepting new patients

Locations

307 W Upshur Ave
Gladewater, TX 75647
Phone (903) 845-2159

201 E 2nd
Hughes Springs, TX 75656
Phone (903) 639-2004

4002 Technology Ctr
Longview, TX 75605
Phone (903) 247-0484

Organizations & group practices 2

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 1

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": "1663545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663545600000",
    "number": "1578286266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12675 COUNTY ROAD 463",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757064206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12675 COUNTY ROAD 463",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757064206",
            "telephone_number": "903-630-0774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGOWEN",
        "first_name": "TIARA",
        "middle_name": "CHANTE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-19",
        "last_updated": "2022-09-19",
        "certification_date": "2022-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1073951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.