Individual provider Active NPI

Tara L Stauffer

  • Counselor
  • Twin Falls, ID
National Provider Identifier
1104661982
Registry record updated Jun 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
COUI10612 Issued in ID
Practice address
1373 Fillmore St
Twin Falls, ID 83301-3392
Phone
(208) 737-9999
NPI assigned
Jun 25, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X COUI10612 ID Primary

Addresses

Primary practice location

1373 Fillmore St
Twin Falls, ID 83301-3392

Mailing address

1373 Fillmore St
Twin Falls, ID 83301-3392
Phone (208) 737-9999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
COUI10612IDMDCounselor

NPI Registry JSON

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

{
    "created_epoch": "1719273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1104661982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1373 FILLMORE ST",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833013392",
            "telephone_number": "208-737-9999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1373 FILLMORE ST",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833013392",
            "telephone_number": "208-737-9999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAUFFER",
        "first_name": "TARA",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-25",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "ID",
            "license": "COUI10612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Twin Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2024; 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.