Individual provider Active NPI

Tanganyika Lynn Dudley, APRN, AGACNP-BC

  • Nurse Practitioner
  • Paris, TX
National Provider Identifier
1962066688
Registry record updated Mar 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP140296 Issued in TX
Practice address
1055 Clarksville St Ste 110
Paris, TX 75460-0210
Phone
(903) 785-3300
Fax
(903) 785-3310
NPI assigned
Apr 29, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP140296 TX Primary
Nurse Practitioner 363L00000X 132422 OK

Addresses

Primary practice location

1055 Clarksville St Ste 110
Paris, TX 75460-0210

Mailing address

1133 Medical Dr
Tyler, TX 75701-2130
Phone (903) 595-5486

Other practice location 1

1104 E Lincoln Rd
Idabel, OK 74745-7364
Phone (903) 785-3300

Other practice location 2

103 Medical Cir Bldg 3
Sulphur Springs, TX 75482-2138
Phone (903) 785-3300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, OK2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20190910003423 TX Practitioner - Nurse Practitioner 5597094987 Reassigns benefits to 1 organization
I20200730001079 OK Practitioner - Nurse Practitioner 5597094987 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Tyler Nephrology Associates PAGroup PAC ID 6901862242, 27 clinicians

Practice addresses (Care Compare)

1055 Clarksville St
Suite 110
Paris, TX 75460-0210
Phone (903) 785-3300

403 S Indian Rd
Idabel, OK 74745-5458
Phone (903) 785-3300

Hospital & facility affiliations

  • Paris Regional Medical Center Hospital, Paris, TX, CCN 450196
  • McCurtain Memorial Hospital Hospital, Idabel, OK, CCN 371342
  • Christus Mother Frances Hospital Sulphur Springs Hospital, Sulphur Springs, TX, CCN 450236
  • Titus Regional Medical Center Hospital, Mount Pleasant, TX, CCN 450080
  • Christus Mother Frances Hospital- Winnsboro Hospital, Winnsboro, TX, CCN 451381

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
132422OKMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tyler Nephrology Associates, P.a. CurrentSince Mar 2, 2020 Accepting new patients

Locations

1104 E Lincoln Rd
Idabel, OK 74745
Phone (580) 286-5030

403 S Indian Rd
Idabel, OK 74745
Phone (580) 286-6688

635 Stone Ave
Paris, TX 75460
Phone (903) 785-3300

1055 Clarksville St
Ste 110
Paris, TX 75460
Phone (903) 784-7472

105 Medical Cir
Bldg 3
Sulphur Springs, TX 75482
Phone (903) 785-3300

1133 Medical Dr
Tyler, TX 75701
Phone 9035955486173

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: tdudley32233@direct.acumenmd.com

Organizations & group practices 1

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 6

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": "1556496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772755200000",
    "number": "1962066688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1133 MEDICAL DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757012130",
            "telephone_number": "903-595-5486",
            "fax_number": "903-595-5128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 CLARKSVILLE ST STE 110",
            "city": "PARIS",
            "state": "TX",
            "postal_code": "754600210",
            "telephone_number": "903-785-3300",
            "fax_number": "903-785-3310"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1104 E Lincoln Rd",
            "address_purpose": "LOCATION",
            "city": "Idabel",
            "state": "OK",
            "postal_code": "747457364",
            "country_code": "US",
            "telephone_number": "903-785-3300",
            "fax_number": "903-785-3310",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "103 Medical Cir Bldg 3",
            "address_purpose": "LOCATION",
            "city": "Sulphur Springs",
            "state": "TX",
            "postal_code": "754822138",
            "country_code": "US",
            "telephone_number": "903-785-3300",
            "fax_number": "903-785-3310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUDLEY",
        "first_name": "TANGANYIKA",
        "middle_name": "LYNN",
        "credential": "APRN, AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-29",
        "last_updated": "2026-03-06",
        "certification_date": "2026-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP140296",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OK",
            "license": "132422",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paris, TX

Sources for this page

Verify at the official NPI Registry.