Tara Zebadua, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

19411 Issued in SC

Practice address

1303 38TH Ave N
Myrtle Beach, SC 29577-1315

Phone

(866) 389-2727

NPI assigned

Apr 20, 2015

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

Medicare fee-for-service enrollment

Enrolled in SC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Life in a Blender Family Medicine, LLC

  • Family Medicine Physician
  • Conway, SC
  • NPI 1235574740
  Medicare reassignment

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

{
    "created_epoch": "1429488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544313600000",
    "number": "1184011900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "269 DEEP BLUE DR",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295793557",
            "telephone_number": "843-685-3003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1303 38TH AVE N",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295771315",
            "telephone_number": "866-389-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZEBADUA",
        "first_name": "TARA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-20",
        "last_updated": "2018-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "19411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David W. Zaenger, MD
• Christopher Bosh Zakhary, M.D.
• Amy Lee Zanelli, ADC
• Dana Becker Zanone, M.D.
• Peter Zawaski, CAC II
• Cheryl Lori Zeidman, PA-C
• Kassie Chandley Zeis, OTR/L
• Alexis Jade Zellers
• Jennifer A Zeuschner, LPC
• Matthew David Zeuschner, AGACNP

• Family Nurse Practitioner in Myrtle Beach, SC
• Providers in Myrtle Beach, SC by specialty
• Family Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.