Active NPI
Tara Ladawn Phillips, FNP-C
- Family Nurse Practitioner
- Wake Village, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 1052397
- Practice address
- 4701 W 7TH St
Wake Village, TX 75501-6255 - Phone
- (903) 831-4065
- Fax
- (903) 831-4075
- NPI assigned
- Aug 29, 2018
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 1052397 | TX | Primary |
| Family Nurse Practitioner | 363LF0000X | 225755 | AR | |
| Family Nurse Practitioner | 363LF0000X | R0113302 | OK |
Addresses
Primary practice location
4701 W 7TH St
Wake Village, TX 75501-6255
Mailing address
3515 Richmond Rd
Texarkana, TX 75503-0711
Phone (903) 791-9355
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX, OK, AR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Healthcare Express, LLP
Practice addresses (Care Compare)
1900 NW Expressway
Suite 800
Oklahoma City, OK 73118-1804
Phone (405) 246-0811
23150 I
Suite 30
Bryant, AR 72022-1405
Phone (501) 888-9047
3515 Richmond Rd
Texarkana, TX 75503-0711
Phone (903) 791-9355
4250 N Venetian LN
Fayetteville, AR 72703-5077
Phone (405) 246-0811
5575 Warren Pkwy
Suite 115
Frisco, TX 75034-4063
Phone (405) 246-0811
Hospital & facility affiliations
- McCurtain Memorial Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R0113302 | OK | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Healthcare Express, LLP | Current | Accepting new patients | |
| Healthcare Express, LLP | Current | Accepting new patients | |
| Total Wound Care of Arkansas,LLC | Current | Accepting new patients | |
| Signify Health Medical Associates, PLLC | Nurse Practitioner | Current | Accepting new patients |
| Signify Health, LLC | Nurse Practitioner | Current | Accepting new patients |
| Healthcare Express, LLP | Current | Accepting new patients | |
| H H Y, LLC | Current | Accepting new patients | |
| H H Y, LLC | Current | Accepting new patients | |
| Total Wound Care of Oklahoma, LLC | Current | Accepting new patients | |
| Total Wound Care of Texas LLC | Current | Accepting new patients |
Locations
609 SW 8th St
Bentonville, AR 72712
Phone (479) 966-4055
23150 Interstate 30 N
Bryant, AR 72022
Phone (501) 888-9047
1021 W Collin Raye Dr
De Queen, AR 71832
Phone (870) 518-0018
4250 N Venetian Ln
Fayetteville, AR 72703
125 Arkansas Blvd
Texarkana, AR 71854
Phone (870) 772-9355
1900 NW Expressway
Ste 800
Oklahoma City, OK 73118
Phone (405) 246-0812
10601 S Western Ave
Ste 100
Oklahoma City, OK 73170
1805 Industrial Way
Clarksville, TX 75426
Phone (903) 428-0100
4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037
5575 Warren Pkwy
Ste 115
Frisco, TX 75034
Phone (469) 200-6100
1509 W Loop 281
Longview, TX 75604
Phone (903) 759-9355
12 E Twohig Ave
San Angelo, TX 76903
Phone (325) 340-9899
3515 Richmond Rd
Texarkana, TX 75503
Phone (903) 831-7270
4701 W 7th St
Wake Village, TX 75501
Phone (903) 831-4065
Organizations & group practices 12
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.
-
- Internal Medicine Physician
- McKinney, TX
- NPI 1225741937
-
- Internal Medicine Physician
- Fayetteville, AR
- NPI 1205655008
-
- Internal Medicine Physician
- Oklahoma City, OK
- NPI 1972269033
-
- Urgent Care Clinic/Center
- Clarksville, TX
- NPI 1225415565
-
- General Practice Physician
- Dallas, TX
- NPI 1750845863
Nurse Practitioner
-
- Multi-Specialty Clinic/Center
- Texarkana, TX
- NPI 1427120310
-
- Multi-Specialty Clinic/Center
- Texarkana, AR
- NPI 1780029892
-
- Rural Health Clinic/Center
- Clarksville, TX
- NPI 1801367149
-
- Family Medicine Physician
- Marshall, TX
- NPI 1639453475
-
- Physical Therapy Clinic/Center
- Texarkana, TX
- NPI 1881101996
-
- Urgent Care Clinic/Center
- Dequeen, AR
- NPI 1487149985
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Idabel, OK
- NPI 1063900975
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1535500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1765756800000",
"number": "1801378641",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3515 RICHMOND RD",
"city": "TEXARKANA",
"state": "TX",
"postal_code": "755030711",
"telephone_number": "903-791-9355",
"fax_number": "903-793-0496"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4701 W 7TH ST",
"city": "WAKE VILLAGE",
"state": "TX",
"postal_code": "755016255",
"telephone_number": "903-831-4065",
"fax_number": "903-831-4075"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIPS",
"first_name": "TARA",
"middle_name": "LADAWN",
"credential": "FNP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-08-29",
"last_updated": "2025-12-15",
"certification_date": "2025-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "TX",
"license": "1052397",
"primary": true
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "AR",
"license": "225755",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "OK",
"license": "R0113302",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Wake Village, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2025; 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.