PHOENIX HEALTH CENTER
NPI 1295157337
Family Medicine in Tyler, TX
About Phoenix Health Center NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PHOENIX HEALTH CENTER (NPI 1295157337) is a healthcare organization registered as a family medicine in Tyler, Texas and active in the NPI registry since January 2014. The organization holds a CLIA Waiver certificate valid through March 5, 2028 and lists Dorothy Louise Jackson, Sole Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Phoenix Health Center is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by January 31, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Phoenix Health Center, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 45D2074345
Phoenix Health Center · Tyler, TXFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Phoenix Health Center, PLLC's NPI number?
The NPI number for Phoenix Health Center, PLLC is 1295157337. It was assigned to this organization in the NPPES registry on January 8, 2014. The provider is doing business as Phoenix Health Center.
Where is Phoenix Health Center, PLLC located?
Phoenix Health Center, PLLC is located at 1114 W Bow St, Tyler, TX 75702. The listed phone number is (903) 595-5595.
What is Phoenix Health Center, PLLC's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Phoenix Health Center, PLLC enrolled in Medicare?
Yes. Phoenix Health Center, PLLC is registered in the Medicare PECOS enrollment system.
When is Phoenix Health Center, PLLC's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Texas, Clinic/Group Practice) is due for revalidation by January 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Phoenix Health Center, PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Phoenix Health Center, PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Phoenix Health Center, PLLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 45D2074345) is associated with this NPI, valid through March 5, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Phoenix Health Center, PLLC was last updated on June 24, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Phoenix Health Center · NPI 1295157337
Family Medicine organization in Tyler, Texas. Organization record, active in the CMS NPPES registry since January 8, 2014.
## Identity
- **NPI:** 1295157337 (Entity type: Organization)
- **Enumerated:** January 8, 2014
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Legal business name:** Phoenix Health Center, Pllc
- **Organization subpart:** No
- **Authorized official:** Dorothy Jackson, SOLE OWNER
## Practice location
- **Address:** 1114 W BOW ST, Tyler, TX 75702-5137
- **Phone:** (903) 595-5595 · **Fax:** (903) 595-5985
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** January 31, 2027 (Non-DME Part B, Texas, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 1 clinician (Family Practice) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** June 24, 2014
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1295157337) · Data from the CMS NPPES public registry.