Tara Gann, NP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

AP7879 Issued in AZ

Practice address

405 W Main St Ste B
Payson, AZ 85541-5345

Phone

(928) 472-6000

Fax

(844) 752-8246

NPI assigned

Jun 10, 2015

Last updated

Sep 13, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Tara Dalhaug Former name

Medicare fee-for-service enrollment

Enrolled in AZ

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Tara Gann DNP

  dba Gann Healthcare and Sleep Lab

  • Primary Care Nurse Practitioner
  • Payson, AZ
  • NPI 1578072872
  Authorized official Same address or phone
• Grant Clinic LLC

  • Addiction Medicine (Anesthesiology) Physician
  • Payson, AZ
  • NPI 1528490968

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1433894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568332800000",
    "number": "1043691520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1503 W COUNTRY CLUB DR",
            "city": "PAYSON",
            "state": "AZ",
            "postal_code": "855414611",
            "telephone_number": "928-951-2189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 W MAIN ST STE B",
            "city": "PAYSON",
            "state": "AZ",
            "postal_code": "855415345",
            "telephone_number": "928-472-6000",
            "fax_number": "844-752-8246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANN",
        "first_name": "TARA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-10",
        "last_updated": "2019-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "AZ",
            "license": "AP7879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TARA",
            "last_name": "DALHAUG",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Primary Care Nurse Practitioner in Payson, AZ
• Providers in Payson, AZ by specialty
• Primary Care Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2019; 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.