Tara Robertson, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209012568 Issued in IL

Practice address

1 Dot Way
Mount Sterling, IL 62353-1664

Phone

(217) 773-6060

Fax

(217) 436-6762

NPI assigned

May 11, 2015

Last updated

Mar 26, 2019By the provider in NPPES

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

Other names 1

• Tara Venvertloh Former name

Medicare fee-for-service enrollment

Enrolled in IL, MO2 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

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Riverside Dermatology and Spa LLCGroup PAC ID 7214282227, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Blessing Hospital Hospital, Quincy, IL, CCN 140015

Merit-based Incentive Payment System (MIPS)

Final score

93.68 of 100Reported as group

Quality

98.81

Improvement activities

40

Cost

80.52

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Riverside Dermatology & Spa LLC

  • Multi-Specialty Clinic/Center
  • Hannibal, MO
  • NPI 1699262329
  Medicare reassignment Care Compare group NPD
• Integrated Dermatology of Northeast Missouri LLC

  • Dermatology Physician
  • Hannibal, MO
  • NPI 1992518658
  Medicare reassignment NPD
• Premise Health of Illinois Medical PC

  dba Dot Mt. Sterling Family Health Center

  • Primary Care Clinic/Center
  • Mt Sterling, IL
  • NPI 1205300159
  NPD (past)

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

• Blessing Hospital

  • Nurse Practitioner
  • Quincy, IL
  • NPI 1417204827

  Hospital

  Care Compare affiliation
• Blessing Hospital

  • General Acute Care Hospital
  • Quincy, IL
  • NPI 1760571699
  Care Compare affiliation

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

{
    "created_epoch": "1431302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553558400000",
    "number": "1104204122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1531 WINSOR DR",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623051471",
            "telephone_number": "217-440-5089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 DOT WAY",
            "city": "MOUNT STERLING",
            "state": "IL",
            "postal_code": "623531664",
            "telephone_number": "217-773-6060",
            "fax_number": "217-436-6762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "TARA",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-11",
        "last_updated": "2019-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209012568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TARA",
            "last_name": "VENVERTLOH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Premise Health of Illinois Medical PC (Dot Mt. Sterling Family Health Center)
• Quincy Physicians & Surgeons Clinic, PLLC
• Quincy Physicians & Surgeons Clinic, PLLC (Quincy Medical Group Mt. Sterling Affiliate)
• Erica Reische
• Jessica Louise Rickey, CADC
• Lindsey Michele Rush, APRN
• Molly Ryssman, COTA
• John Thomas Schneider
• Jennifer S Schroeder, MD
• Kayla A. Sipes

• Family Nurse Practitioner in Mt Sterling, IL
• Providers in Mt Sterling, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.