Tara L Bruner, P.A.-C
Individual provider Active NPI Medical Physician Assistant · Searcy, AR
NPI 1013082205 · NPPES record last updated Jan 8, 2009
Key facts
- NPI
- 1013082205
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical Physician Assistant 363AM0700X
- License
- PA-355 (AR)
- Practice address
- 205 East Race Avenue
Searcy, AR 72143-4329 - Phone
- (501) 279-9000
- Fax
- (501) 279-9011
- NPI assigned
- Nov 22, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101018000556 | AR | Practitioner - Physician Assistant | 5092908558 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA-355 | AR | MD | Medical Physician Assistant |
| PA1498 | OK | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| White County Medical Center | Current |
Accepting new patients | |
| White County Medical Center | Current |
Accepting new patients | |
| John Richard Duke Sr MD PLLC Dba Duke Medical | Past |
Accepting new patients |
Locations
2725 Highway 25B
Heber Springs, AR 72543
Phone (501) 362-5800
3214 E Race Ave
Searcy, AR 72143
Phone (501) 268-6121
2900 Hawkins Dr
Searcy, AR 72143
Phone (501) 278-2800
2902 E Race Ave
Searcy, AR 72143
Phone (501) 236-0225
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/BAIAAA/Endpoint/BAIAAA
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA-355 | AR | Yes |
| Medical Physician Assistant | 363AM0700X | PA1498 | OK |
Addresses
Primary practice location
205 East Race Avenue
Searcy, AR 72143-4329
Mailing address
212 Indian TRL
Searcy, AR 72143-5922
Phone (405) 650-8354
Other providers in Searcy, AR
- Terry Brown
- Hannah Brooke Brownfield
- Kimberly Ann Browning
- Bruce K. Berkheimer, P.a.
- Joe Stephen Brumfield
- Courtney Bryan
- Brenda Bryant
- Lorna Bryant
- Vinson Lee Bryant
- Braden Robert Buchanan
All providers in Searcy, AR · Medical Physician Assistant in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 8, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.