1. Home
  2. Directory
  3. Texas
  4. Tyler
  5. General Acute Care Hospital
  6. NPI Profile

TYLER REGIONAL HOSPITAL LLC
NPI 1407364847
General Acute Care Hospital in Tyler, TX

Active since January 19, 2018CLIA Certified · 2 labs
1000 S BECKHAM AVE, TYLER, TX 75701(903) 597-0351(903) 535-6334 Get Directions Write a Review

NPPES record last updated: October 2, 2023. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Oct 2, 2023, Jan 19, 2018 (2 updates tracked since 2018).

About Tyler Regional Hospital Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TYLER REGIONAL HOSPITAL LLC (NPI 1407364847) is a healthcare organization registered as a general acute care hospital in Tyler, Texas and active in the NPI registry since January 2018. The organization holds 2 active CLIA laboratory certificates and lists Stephen C Petrovich, Evp And Secretary, as its authorized official.

NPPES Registry Identity

NPI1407364847
Entity TypeOrganization
Primary Taxonomy282N00000X
Legal Business NameTYLER REGIONAL HOSPITAL LLC
Location Address1000 S BECKHAM AVETyler, TX 75701-1908
Mailing Address340 Seven Springs Way Ste 100Brentwood, TN 37027-5697 · (615) 296-3000 · Fax (615) 296-6227
Phone(903) 597-0351
Fax(903) 535-6334
Organization SubpartYesParent: Ahs East Texas Health System, Llc
Authorized OfficialStephen C PetrovichEvp And Secretary · (615) 296-3000
Enumeration DateJanuary 19, 2018
Last NPPES UpdateOctober 2, 20232 updates tracked since enumeration
NPPES CertifiedOctober 2, 2023
✔ NPI 1407364847 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral Acute Care HospitalHospitals
Taxonomy Code282N00000X
Definition
An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity.
1000 S BECKHAM AVE, Tyler, TX 75701
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA 2

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 Accreditation 45D0940696

Tyler Regional Hospital, LLC · Tyler, TX
Active · expires Oct 18, 2028
CLIA Number45D0940696
Laboratory TypeOther
Certificate Effective DateOctober 19, 2026
Certificate Expiration DateOctober 18, 2028
Laboratory DirectorDr. Foy G. Forehand
Laboratory Phone(903) 579-2750
Laboratory LocationTyler Regional Hospital, LLC6210 South Broadway Atnn Lab-, Tyler, TX 75703
CLIA data matches this NPI record on: Name
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Certificate of Accreditation 45D2320601

Tyler Regional Hospital, LLC S Broadway Pulmonary Abg Lab · Tyler, TX
Active · expires Sep 14, 2027
CLIA Number45D2320601
Laboratory TypeHospital
Certificate Effective DateSeptember 15, 2025
Certificate Expiration DateSeptember 14, 2027
Laboratory DirectorLuis A. Destarac
Laboratory Phone(903) 579-2800
Laboratory LocationTyler Regional Hospital, LLC S Broadway Pulmonary Abg Lab6210 S Broadway Ave, Tyler, TX 75703
CLIA data matches this NPI record on: Name
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MUHAMMAD KAFEEL SARWAR M.D.
Internal Medicine
1000 S BECKHAM AVE
TYLER, TX 75701
Smith County (903) 590-5611
JOHN GLYNN JEANSONNE CRNA
Nurse Anesthetist, Certified Registered
1000 S BECKHAM AVE
TYLER, TX 75701
Smith County (903) 526-1068
MAHIDER GEDAMU
Nurse Practitioner (Acute Care)
1000 S BECKHAM AVE
TYLER, TX 75701
Smith County (903) 597-0351
ARAMISH SAEED KHAN
Student in an Organized Health Care Education/Training Program
1000 S BECKHAM AVE
TYLER, TX 75701
Smith County (903) 594-2269
DR. FARZAD FAKOURI M.D. , MPH
Internal Medicine
1000 S BECKHAM AVE
TYLER, TX 75701
Smith County (903) 590-5611
SHANNON PARKER FNP-C
Nurse Practitioner (Family)
1000 S BECKHAM AVE
TYLER, TX 75701
Smith County (903) 595-5514
ARNULFO DUARTE DO
Internal Medicine
1000 S BECKHAM AVE
TYLER, TX 75701
Smith County (903) 590-5611
HAROLD RICHIE BANDALAN CRNA
Nurse Anesthetist, Certified Registered
1000 S BECKHAM AVE
TYLER, TX 75701
Smith County (903) 526-1068

Frequently 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 Tyler Regional Hospital LLC's NPI number?

The NPI number for Tyler Regional Hospital LLC is 1407364847. It was assigned to this organization in the NPPES registry on January 19, 2018.

Where is Tyler Regional Hospital LLC located?

Tyler Regional Hospital LLC is located at 1000 S Beckham Ave, Tyler, TX 75701. The listed phone number is (903) 597-0351.

What is Tyler Regional Hospital LLC's specialty?

The primary specialty registered for this NPI is General Acute Care Hospital with taxonomy code 282N00000X.

Does Tyler Regional Hospital LLC hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Tyler Regional Hospital LLC accept?

Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 3 other insurers list Tyler Regional Hospital LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Tyler Regional Hospital LLC was last updated on October 2, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.