Tara J Jackson-Farmer

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

197170 Issued in NC

Practice address

3715 Business Drive
Suite 202
Fayetteville, AR 72703-5204

Phone

(252) 452-5038

Fax

(479) 582-0778

NPI assigned

May 6, 2019

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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 and National Provider Directory roles.

• Trestletree, LLC

  • Psychologist
  • Fayetteville, AR
  • NPI 1598291478

  Registered Nurse

  NPD (past)

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

{
    "created_epoch": "1557100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557100800000",
    "number": "1093370033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3715 BUSINESS DRIVE",
            "address_2": "SUITE 202",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727035204",
            "telephone_number": "252-452-5038",
            "fax_number": "479-582-0778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3715 BUSINESS DRIVE",
            "address_2": "SUITE 202",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727035204",
            "telephone_number": "252-452-5038",
            "fax_number": "479-582-0778"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4719 Chippenham Rd",
            "address_purpose": "LOCATION",
            "city": "Rocky Mount",
            "state": "NC",
            "postal_code": "278049521",
            "country_code": "US",
            "telephone_number": "646-220-4294",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON-FARMER",
        "first_name": "TARA",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-06",
        "last_updated": "2019-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "197170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aneeqa Ishtiaq, M.S., LPC
• Marie N Isler
• Kristen Isles
• Jasmine Istre
• J Cole White DDS PA
• Amber Adney Jackson, LCSW
• Carol Jackson, LISW - S, LICDC
• Charles David Jackson, MD
• Charles Mark Jackson, M.D.
• Edward Leslie Jackson, M.D.

• Registered Nurse in Fayetteville, AR
• Providers in Fayetteville, AR by specialty
• Registered Nurse in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.