NPIMap

Organization Active NPI

Trinity Clinic

Doing business as Trinity Clinic Family Practice

  • Family Medicine Physician
  • Tyler, TX
National Provider Identifier
1922058304
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
TRINITY CLINIC
Doing business as
Trinity Clinic Family Practice
Practice address
520 East Douglas
Tyler, TX 75702
Phone
(903) 531-5185
NPI assigned
May 10, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Lynda Kaye Tippit
Title
Supervisor, Central Cred
Phone
(903) 531-5185

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

520 East Douglas
Tyler, TX 75702

Mailing address

PO Box 5500
Tyler, TX 75712-5500
Phone (903) 324-6450

Other names 1

  • TRINITY CLINIC FAMILY PRACTICE Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Tyler Radiologist25 organizations share this tax ID, including this one

Other organizations with this tax ID 24

Organizations that report the same tax identification number in the National Provider Directory.

View all 24

Locations

520 Douglas Blvd
Tyler, TX 75702
Phone (903) 510-1175

Practitioners & affiliated clinicians

Practitioners 399

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.

View all 399

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1922058304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5500",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757125500",
            "telephone_number": "903-324-6450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 EAST DOUGLAS",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "75702",
            "telephone_number": "903-531-5185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRINITY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TIPPIT",
        "authorized_official_first_name": "LYNDA",
        "authorized_official_middle_name": "KAYE",
        "authorized_official_title_or_position": "SUPERVISOR, CENTRAL CRED",
        "authorized_official_telephone_number": "903-531-5185"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TRINITY CLINIC FAMILY PRACTICE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.