Active NPI
Tara E. Kegeris, FNP-C
- Family Nurse Practitioner
- Avon, IN
National Provider Identifier
1184009961
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 71005791A
- Practice address
- 8607 E US Highway 36 Ste 100
Avon, IN 46123-7960 - Phone
- (317) 745-5403
- NPI assigned
- Jul 22, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 71005791A | IN | Primary |
Addresses
Primary practice location
8607 E US Highway 36 Ste 100
Avon, IN 46123-7960
Mailing address
8607 E US Highway 36 Ste 100
Avon, IN 46123-7960
Phone (317) 745-5403
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | tara.kegerisfnpc.p2@direct.ahni.nextgenshare.com | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective May 2, 2022 through May 2, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71005791A | IN | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1437523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1646179200000",
"number": "1184009961",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8607 E US HIGHWAY 36 STE 100",
"city": "AVON",
"state": "IN",
"postal_code": "461237960",
"telephone_number": "317-745-5403"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8607 E US HIGHWAY 36 STE 100",
"city": "AVON",
"state": "IN",
"postal_code": "461237960",
"telephone_number": "317-745-5403"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEGERIS",
"first_name": "TARA",
"middle_name": "E.",
"credential": "FNP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-07-22",
"last_updated": "2022-03-02",
"certification_date": "2022-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IN",
"license": "71005791A",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "tara.kegerisfnpc.p2@direct.ahni.nextgenshare.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CCDA",
"address_1": "8607 E US Highway 36 Ste 100",
"city": "Avon",
"state": "IN",
"country_code": "US",
"postal_code": "461237960",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Avon, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.