Individual provider Active NPI

Tara Ladawn Phillips, FNP-C

  • Family Nurse Practitioner
  • Wake Village, TX
National Provider Identifier
1801378641
Registry record updated Dec 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1052397 Issued in TX
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

Updated by the provider on Dec 15, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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, AR3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20231013002442 TX Practitioner - Nurse Practitioner 5395190177 Reassigns benefits to 4 organizations
I20240304001389 OK Practitioner - Nurse Practitioner 5395190177 Reassigns benefits to 2 organizations
I20250417001429 AR Practitioner - Nurse Practitioner 5395190177 Reassigns benefits to 2 organizations

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
Total Wound Care of Oklahoma LLCGroup PAC ID 1254724081, 15 clinicians
Healthcare Express, LLPGroup PAC ID 9739131442, shared by 7 NPIs, 68 clinicians
Total Wound Care of Arkansas,LLCGroup PAC ID 3375064918, 5 clinicians
Total Wound Care of Texas LLCGroup PAC ID 0648644138, 9 clinicians

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 Hospital, Idabel, OK, CCN 371342

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R0113302OKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Healthcare Express, LLP CurrentSince Jan 5, 2026 Accepting new patients
Healthcare Express, LLP CurrentSince Jan 5, 2026 Accepting new patients
Total Wound Care of Arkansas,LLC CurrentSince Feb 4, 2025 Accepting new patients
Signify Health Medical Associates, PLLC Nurse Practitioner CurrentSince Aug 27, 2023 Accepting new patients
Signify Health, LLC Nurse Practitioner CurrentSince Mar 7, 2024 Accepting new patients
Healthcare Express, LLP CurrentSince Jan 5, 2026 Accepting new patients
H H Y, LLC CurrentSince Dec 2, 2024 Accepting new patients
H H Y, LLC CurrentSince Dec 2, 2024 Accepting new patients
Total Wound Care of Oklahoma, LLC CurrentSince Jan 2, 2024 Accepting new patients
Total Wound Care of Texas LLC CurrentSince Jan 23, 2024 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.

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": "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

Verify at the official NPI Registry.