Individual provider Active NPI

John P Tyson, MD

  • Family Medicine Physician
  • Denison, TX
National Provider Identifier
1851337687
Registry record updated Sep 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01088 Issued in TX
Practice address
1014 Memorial Dr
1St Floor
Denison, TX 75020-2079
Phone
(903) 416-6000
Fax
(903) 416-6154
NPI assigned
Jun 21, 2006
Last updated
Sep 11, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01088 TX Primary

Addresses

Primary practice location

1014 Memorial Dr
1St Floor
Denison, TX 75020-2079

Mailing address

1014 Memorial Dr
Denison, TX 75020-2079
Phone (903) 416-6000

Other identifiers 1

IdentifierTypeStateIssuer
098755402MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01088TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Uhs of Texoma Inc Past Accepting new patients
Texomacare Family Medicine Past Accepting new patients

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, 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": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221091200000",
    "number": "1851337687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1014 MEMORIAL DR",
            "city": "DENISON",
            "state": "TX",
            "postal_code": "750202079",
            "telephone_number": "903-416-6000",
            "fax_number": "903-416-6154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1014 MEMORIAL DR",
            "address_2": "1ST FLOOR",
            "city": "DENISON",
            "state": "TX",
            "postal_code": "750202079",
            "telephone_number": "903-416-6000",
            "fax_number": "903-416-6154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYSON",
        "first_name": "JOHN",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-21",
        "last_updated": "2008-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "01088",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "098755402",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denison, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.