Individual provider Active NPI

Stephanie Helene Tatalos, RN, WHNP-BC

  • Women's Health Nurse Practitioner
  • Denton, TX
National Provider Identifier
1629071162
Registry record updated Jan 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
455586 Issued in TX
Practice address
3537 S I-35 E
Ste 210
Denton, TX 76210-6800
Phone
(940) 381-2313
Fax
(940) 381-5249
NPI assigned
May 28, 2005
Last updated
Jan 29, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 455586 TX Primary

Addresses

Primary practice location

3537 S I-35 E
Ste 210
Denton, TX 76210-6800

Mailing address

2821 Newport Ave
Denton, TX 76209-4719
Phone (940) 566-5244

Other identifiers 1

IdentifierTypeStateIssuer
018463204MedicaidTX

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
I20031105000637 TX Practitioner - Nurse Practitioner 6103738257 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Denton County Health Department CurrentSince Jul 12, 2014 Accepting new patients

Locations

535 S Loop 288
Ste 1003
Denton, TX 76205
Phone (940) 349-2900

190 N Valley Pkwy
Lewisville, TX 75067
Phone (972) 434-4700

Organizations & group practices 1

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": "1117238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359417600000",
    "number": "1629071162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2821 NEWPORT AVE",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762094719",
            "telephone_number": "940-566-5244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3537 S I-35 E",
            "address_2": "STE 210",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762106800",
            "telephone_number": "940-381-2313",
            "fax_number": "940-381-5249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATALOS",
        "first_name": "STEPHANIE",
        "middle_name": "HELENE",
        "name_prefix": "Ms.",
        "credential": "RN, WHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-05-28",
        "last_updated": "2013-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "TX",
            "license": "455586",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "018463204",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denton, TX

Sources for this page

Verify at the official NPI Registry.