Individual provider Active NPI

Tara Irvin, CRNP

  • Nurse Practitioner
  • Chambersburg, PA
National Provider Identifier
1154728442
Registry record updated Jun 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP014167 Issued in PA
Practice address
12 St Paul Dr Ste 210
Chambersburg, PA 17201-1035
Phone
(717) 217-6820
Fax
(717) 217-6942
NPI assigned
Dec 2, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP014167 PA
Nurse Practitioner 363L00000X SP014167 PA Primary

Addresses

Primary practice location

12 St Paul Dr Ste 210
Chambersburg, PA 17201-1035

Mailing address

785 5TH Ave Ste 3
Chambersburg, PA 17201-4232
Phone (717) 263-9555

Other practice location 1

601 E Main St
Waynesboro, PA 17268-2332
Phone (717) 217-6820

Other practice location 2

24 Antrim Commons Dr
Greencastle, PA 17225-1623
Phone (717) 217-6820

Other practice location 3

354 Alexander Spring Rd
Carlisle, PA 17015-7451
Phone (717) 217-6820

Other identifiers 1

IdentifierTypeStateIssuer
102995936MedicaidPA

Other names 1

  • Tara Miller Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20150128000717 PA Practitioner - Nurse Practitioner 1456675172 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wellspan Medical GroupGroup PAC ID 1951213115, 2,438 clinicians

Practice addresses (Care Compare)

40 V Twin Dr
Suite 205
Gettysburg, PA 17325-7878
Phone (717) 339-2790

Hospital & facility affiliations

  • Wellspan Chambersburg Hospital Hospital, Chambersburg, PA, CCN 390151
  • Wellspan Waynesboro Hospital Hospital, Waynesboro, PA, CCN 390138
  • Fulton County Medical Center Hospital, McConnellsburg, PA, CCN 391303
  • Gettysburg Hospital Hospital, Gettysburg, PA, CCN 390065

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP014167PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellspan Medical Group CurrentSince Jul 1, 2021 Accepting new patients
Wellspan Medical Group CurrentSince Jul 1, 2021 Accepting new patients
Wellspan Medical Group Current Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

354 Alexander Spring Rd
Carlisle, PA 17015
Phone (717) 217-6870

354 Alexander Spring Rd
Ste 3
Carlisle, PA 17015
Phone (717) 217-6820

12 St Paul Dr
Ste 210
Chambersburg, PA 17201
Phone (717) 217-6820

40 V Twin Dr
Ste 205
Gettysburg, PA 17325
Phone (717) 339-2790

24 Antrim Commons Dr
Greencastle, PA 17225
Phone (717) 593-0512

501 E Main St
Waynesboro, PA 17268
Phone (717) 765-3400

601 E Main St
Waynesboro, PA 17268
Phone (717) 765-5085

1600 S George St
York, PA 17403
Phone (717) 848-3615

25 Monument Rd
Ste 270
York, PA 17403
Phone (717) 741-8250

Interoperability endpoints

  • Direct secure messaging: tirvin225876@wellspan.direct-ci.com

Organizations & group practices 4

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.

Hospital & facility affiliations 10

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": "1417478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592265600000",
    "number": "1154728442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "785 5TH AVE STE 3",
            "city": "CHAMBERSBURG",
            "state": "PA",
            "postal_code": "172014232",
            "telephone_number": "717-263-9555",
            "fax_number": "717-217-4218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 ST PAUL DR STE 210",
            "city": "CHAMBERSBURG",
            "state": "PA",
            "postal_code": "172011035",
            "telephone_number": "717-217-6820",
            "fax_number": "717-217-6942"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 E Main St",
            "address_purpose": "LOCATION",
            "city": "Waynesboro",
            "state": "PA",
            "postal_code": "172682332",
            "country_code": "US",
            "telephone_number": "717-217-6820",
            "fax_number": "717-217-6942",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "24 Antrim Commons Dr",
            "address_purpose": "LOCATION",
            "city": "Greencastle",
            "state": "PA",
            "postal_code": "172251623",
            "country_code": "US",
            "telephone_number": "717-217-6820",
            "fax_number": "717-217-6942",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "354 Alexander Spring Rd",
            "address_purpose": "LOCATION",
            "city": "Carlisle",
            "state": "PA",
            "postal_code": "170157451",
            "country_code": "US",
            "telephone_number": "717-217-6820",
            "fax_number": "717-217-6942",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IRVIN",
        "first_name": "TARA",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-02",
        "last_updated": "2020-06-16",
        "certification_date": "2020-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP014167",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP014167",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102995936",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TARA",
            "last_name": "MILLER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chambersburg, PA

Sources for this page

Verify at the official NPI Registry.