Tara Lynn Favis, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95013467 Issued in CA

Practice address

77 Cadillac Dr Ste 200
Sacramento, CA 95825-8337

Phone

(916) 454-2345

NPI assigned

Jun 14, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA, CA2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/1369/brand/1/csg/1/fhir/r4

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.

• Elica Health Centers

  • Federally Qualified Health Center (FQHC)
  • West Sacramento, CA
  • NPI 1548425853
  Medicare reassignment NPD
• Sutter Valley Medical Foundation

  dba Sutter Gould Medical Foundation

  • Multi-Specialty Clinic/Center
  • Modesto, CA
  • NPI 1669846986
  Medicare reassignment NPD
• Lifetime Family Medicine,LLC

  • Family Medicine Physician
  • Dallas, GA
  • NPI 1053509216
  Medicare reassignment NPD
• Wellstar Medical Group, LLC

  dba WellStar Family Medicine ACW

  • Family Medicine Physician
  • Kennesaw, GA
  • NPI 1558664003
  Medicare reassignment NPD
• Elica Health Centers

  • Federally Qualified Health Center (FQHC)
  • Sacramento, CA
  • NPI 1740660703
  NPD
• Elica Health Centers

  • Federally Qualified Health Center (FQHC)
  • Sacramento, CA
  • NPI 1760293351
  NPD
• Sutter Valley Medical Foundation

  • Durable Medical Equipment & Medical Supplies
  • Tracy, CA
  • NPI 1720930712
  NPD
• Sutter North Medical Foundation

  dba Sutter North Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Yuba City, CA
  • NPI 1144251521
  NPD (past)
• Sutter Regional Medical Foundation

  • Family Medicine Physician
  • Fairfield, CA
  • NPI 1558388504
  NPD (past)
• WL MD Atlanta, LLC

  dba MD Low T

  • Health Service Clinic/Center
  • Alpharetta, GA
  • NPI 1831529841
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1339632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1013279132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 HOWE AVE STE 440",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958251098",
            "telephone_number": "916-569-8484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 CADILLAC DR STE 200",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958258337",
            "telephone_number": "916-454-2345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAVIS",
        "first_name": "TARA",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-14",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95013467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Faulkender
• Saneesha Faulkner
• Billy Sefo Faumuina III
• Valencia Isabella Faux
• Michael Rex Favero, DMD
• Kayla Favor
• Rakan Ahmad Fawakhiri, DMD
• Fay Nazari, DDS, PC
• Faye George
• Fayez Romman, MD Inc

• Family Nurse Practitioner in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.