Individual provider Active NPI

Karla Timms, NP

  • Nurse Practitioner
  • Tyler, TX
National Provider Identifier
1962838698
Registry record updated Sep 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
657419 Issued in TX
Practice address
1020 E Idel St
Tyler, TX 75701-2024
Phone
(903) 535-2902
Fax
(903) 535-9217
NPI assigned
Sep 26, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 657419 TX Primary

Addresses

Primary practice location

1020 E Idel St
Tyler, TX 75701-2024

Mailing address

901 Turtle Creek Dr
Tyler, TX 75701-1947
Phone (903) 596-3651

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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 1

Enrollment IDStateProvider typePAC IDDetails
I20140505000714 TX Practitioner - Nurse Practitioner 1355574054 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Etmc Physician Group, Inc.Group PAC ID 4486915600, 375 clinicians

Practice addresses (Care Compare)

1020 E Idel St
Tyler, TX 75701-2024
Phone (903) 535-2902

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
657419TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Etmc Physician Group Inc. CurrentSince Mar 1, 2018 Accepting new patients
Etmc Physician Group Inc. CurrentSince Mar 1, 2018 Accepting new patients
East Texas Medical Center Past Accepting new patients
Radiology Associates of North Texas PA Past Accepting new patients

Locations

18118 FM 344 W
Flint, TX 75762
Phone (903) 825-3292

1020 E Idel St
Tyler, TX 75701
Phone (903) 535-2902

901 Turtle Creek Dr
Tyler, TX 75701
Phone (903) 594-2418

Interoperability endpoints

  • Direct secure messaging: ktimms354916@ahs.direct-ci.com

Organizations & group practices 4

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": "1380153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380153600000",
    "number": "1962838698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 TURTLE CREEK DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757011947",
            "telephone_number": "903-596-3651",
            "fax_number": "903-594-2038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 E IDEL ST",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757012024",
            "telephone_number": "903-535-2902",
            "fax_number": "903-535-9217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIMMS",
        "first_name": "KARLA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-26",
        "last_updated": "2013-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "657419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.