TARA LADAWN PHILLIPS (FNP-C) – General Practice Registered Nurse, NPI 1801378641

TARA LADAWN PHILLIPS (FNP-C) is a healthcare provider. based in Idabel, Oklahoma. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP-C. They hold a License No. 1052397 (TX). The NPI Number for TARA LADAWN PHILLIPS (FNP-C) is 1801378641

Main info

Female
8 Years Of Experience
Accepts Medicare Assignment
Name
TARA LADAWN PHILLIPS (FNP-C)
NPI
1801378641
Phone
(580) 212-1856
Address
410 MOONLIGHT ST
Enumeration Date
29 August 2018
Last Update Date
15 December 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4052460811
Graduation Year
2018 (8 years ago)
PAC ID
5395190177
Group Practice PAC ID
3375064918
Professional Enrollment ID
I20250417001429
Address ID
AR727035077FA4250XLNXX400
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience66
Completeness85
Years active:7State licenses:3Digital endpointsOther names

3,299 NURSE PRACTITIONER in OK

Provider Addresses for TARA LADAWN PHILLIPS (FNP-C)

  • 410 MOONLIGHT ST

    IDABEL, OK 747458108

    Phone: (580) 212-1856

    Type: Location

  • PO BOX 1837

    IDABEL, OK 747451837

    Phone: (580) 212-8624

    Type: Mailing

  • 3515 RICHMOND RD

    TEXARKANA, TX 755030711

    Phone: (903) 791-9355

    Fax: (903) 793-0496

    Type: Mailing

  • 4701 W 7TH ST

    WAKE VILLAGE, TX 755016255

    Phone: (903) 831-4065

    Fax: (903) 831-4075

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 3 Open Payments records for all available years, with a total value of $59.

Total Amount is formed as General ($59) + Research ($0) + Ownership ($0) = $59.

Last reported payment date: 2024-04-20 • Largest payer in this snapshot: Solventum Corporation ($45).

Total Amount

$59

General + Research + Ownership

Payments

3

Total payment records

General Amount

$59

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-04-20

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-04-17

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 3 Medicare enrollment records; no due dates published yet.

Enrollment records

3

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20231013002442INurse PractitionerTXTBD
I20240304001389INurse PractitionerOKTBD
I20250417001429INurse PractitionerARTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 74745)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3375064918View full group profile
NameSpecialtyState
Nurse PractitionerKS
Nurse PractitionerTX
Nurse PractitionerOK

Reviews

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Frequently asked questions

Is there an official ID for TARA LADAWN PHILLIPS (FNP-C) in U.S. healthcare records?
The official identifier for TARA LADAWN PHILLIPS (FNP-C) is NPI 1801378641.
Active or inactive — what applies to TARA LADAWN PHILLIPS (FNP-C)?
You should see TARA LADAWN PHILLIPS (FNP-C) as active in CMS-hosted NPPES data.
What kind of doctor is TARA LADAWN PHILLIPS (FNP-C)?
TARA LADAWN PHILLIPS (FNP-C) is associated with General Practice Registered Nurse in the directory — Clinical services aligned with this taxonomy classification.
Is TARA LADAWN PHILLIPS (FNP-C) located near Idabel?
TARA LADAWN PHILLIPS (FNP-C) currently maps to Idabel, Oklahoma in this extract.
When was this NPI issued?
Enumeration for TARA LADAWN PHILLIPS (FNP-C) is noted as August 29, 2018 where the registry provides it.

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