Active NPI
Urology Tyler, PA
- Urology Physician
- Tyler, TX
National Provider Identifier
1861572968
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- Legal business name
- UROLOGY TYLER, PA
- Practice address
- 700 Olympic Plaza Cir Ste 700
Tyler, TX 75701-1954 - Phone
- (903) 262-3900
- Fax
- (903) 262-3993
- NPI assigned
- Oct 16, 2006
- Last updated
- Aug 14, 2013
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Stanton P. Champion, MD
- Title
- President
- Phone
- (903) 262-3900
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | NU | Primary |
Addresses
Primary practice location
700 Olympic Plaza Cir Ste 700
Tyler, TX 75701-1954
Mailing address
PO Box 8026
Tyler, TX 75711-8026
Phone (903) 262-3900
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 112852203 | Medicaid | TX |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 45D0675621 | Uthet Urology Tyler | Accreditation | Sep 14, 2027 |
National Provider Directory
National Provider DirectoryLocations
1017 E Idel St
Tyler, TX 75701
Phone (903) 590-5150
Practitioners & affiliated clinicians
Practitioners 6
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Anatomic Pathology Physician
- San Antonio, TX
- NPI 1497750681
-
- Anatomic Pathology & Clinical Pathology Physician
- Hurst, TX
- NPI 1750385142
-
- Urology Physician
- Bedford, TX
- NPI 1700826260
-
- Urology Physician
- Tyler, TX
- NPI 1720275043
-
- Anatomic Pathology & Clinical Pathology Physician
- Houston, TX
- NPI 1598727232
-
- Urology Physician
- Latham, NY
- NPI 1649447897
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160956800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1376438400000",
"number": "1861572968",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8026",
"city": "TYLER",
"state": "TX",
"postal_code": "757118026",
"telephone_number": "903-262-3900",
"fax_number": "903-262-3993"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 OLYMPIC PLAZA CIR STE 700",
"city": "TYLER",
"state": "TX",
"postal_code": "757011954",
"telephone_number": "903-262-3900",
"fax_number": "903-262-3993"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "UROLOGY TYLER, PA",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-16",
"last_updated": "2013-08-14",
"status": "A",
"authorized_official_last_name": "CHAMPION",
"authorized_official_first_name": "STANTON",
"authorized_official_middle_name": "P.",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "903-262-3900",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "112852203",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Tyler, TX
- University of Texas Health Science Center at Tyler (Uthsct Hope Pharmacy Specialty)
- University of Texas Health Science Center at Tyler
- University of Texas Health Science Center at Tyler-Facility-Physician
- Ilanko Upendran, MD
- Sara Upson, M.ED, RD, LD
- Olivia Urwiller, MOT, OTR
- Marc Edward Usrey, M.D.
- Usv Optical Inc.
- Vivian Uzodinma
- Derek C Vadasy
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- 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.