Tara Lynn Powell, DNP, APRN, CPNP-PC

Individual provider Active NPI Pediatric Nurse Practitioner · Oakley, KS

NPI 1154936607 · NPPES record last updated Sep 11, 2020

Key facts

NPI
1154936607
Entity type
Individual (NPI type 1)
Primary specialty
Pediatric Nurse Practitioner 363LP0200X
License
53-79180-032 (KS)
Practice address
212 Maple Ave
Oakley, KS 67748-1220
Phone
(785) 672-3261
NPI assigned
Sep 11, 2020
Sex
Female
Sole proprietor
No

Organizations & group practices 3

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.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20201028001437 KS Practitioner - Nurse Practitioner 4486064755 Reassigns benefits to 2 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
53-79180-032KSMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
County of Logan Current Accepting new patients
County of Logan Current Accepting new patients
County of Logan Current
since Sep 22, 2020
Accepting new patients

Locations

212 Maple Ave
Oakley, KS 67748
Phone (785) 672-3261

211 Cherry Ave
Oakley, KS 67748
Phone (785) 672-1409

1001 Highway 40
Ste 4
Oakley, KS 67748
Phone (785) 672-1441

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11985/brand/1/csg/1/fhir/r4
  • Direct secure messaging: tara.powell.1@11985.direct.athenahealth.com

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 53-79180-032 KS Yes

Addresses

Primary practice location

212 Maple Ave
Oakley, KS 67748-1220

Mailing address

215 E Pine St
Colby, KS 67701-3419
Phone (785) 443-3284

Other providers in Oakley, KS

All providers in Oakley, KS · Pediatric Nurse Practitioner in Kansas

Sources for this page

Verify at the official NPI Registry.