Individual provider Active NPI

Tara Beth Tye, NP-C

  • Family Nurse Practitioner
  • Tullahoma, TN
National Provider Identifier
1093340630
Registry record updated Mar 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
27241 Issued in TN
Practice address
100 William Northern Blvd
Tullahoma, TN 37388-4754
Phone
(931) 454-0489
Fax
(931) 454-1227
NPI assigned
Mar 4, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 27241 TN Primary

Addresses

Primary practice location

100 William Northern Blvd
Tullahoma, TN 37388-4754

Mailing address

739 Brandontown Rd
Manchester, TN 37355-7623
Phone (931) 581-4025

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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

Enrollment IDStateProvider typePAC IDDetails
I20200416001190 TN Practitioner - Nurse Practitioner 9638509524 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Practice Center of Tullahoma LLCGroup PAC ID 2769640812, 6 clinicians
Amg-Southern Tennessee LLCGroup PAC ID 5991765943, 54 clinicians

Practice addresses (Care Compare)

100 William N Blvd
Tullahoma, TN 37388-4754
Phone (931) 454-0489

2006 Decherd Blvd
Decherd, TN 37324-3818
Phone (931) 967-0931

730 Kings LN
Tullahoma, TN 37388-5371
Phone (931) 571-8428

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
27241TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tullahoma Immediate Care PC CurrentSince Dec 1, 2022 Accepting new patients
Family Practice Center of Tullahoma LLC CurrentSince Mar 9, 2020 Accepting new patients
Amg-Southern Tennessee LLC CurrentSince Nov 1, 2023 Accepting new patients
Amg-Southern Tennessee LLC CurrentSince Nov 1, 2023 Accepting new patients
Amg -Southern Tennessee LLC Past Accepting new patients

Locations

2006 Decherd Blvd
Decherd, TN 37324
Phone (931) 962-0561

730 Kings Ln
Tullahoma, TN 37388
Phone (931) 393-2121

100 William Northern Blvd
Tullahoma, TN 37388
Phone (931) 454-0489

83 Memorial Dr
Winchester, TN 37398
Phone (931) 967-3966

2118 Cowan Hwy
Winchester, TN 37398
Phone (931) 962-4040

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CDACAA/Endpoint/CDACAA
  • Direct secure messaging: tara.tye.1@19363.direct.athenahealth.com

Organizations & group practices 5

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1583280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583280000000",
    "number": "1093340630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "739 BRANDONTOWN RD",
            "city": "MANCHESTER",
            "state": "TN",
            "postal_code": "373557623",
            "telephone_number": "931-581-4025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WILLIAM NORTHERN BLVD",
            "city": "TULLAHOMA",
            "state": "TN",
            "postal_code": "373884754",
            "telephone_number": "931-454-0489",
            "fax_number": "931-454-1227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYE",
        "first_name": "TARA",
        "middle_name": "BETH",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-04",
        "last_updated": "2020-03-04",
        "certification_date": "2020-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "27241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tullahoma, TN

Sources for this page

Verify at the official NPI Registry.