Tara L Johnson, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

108072 Issued in IA

Practice address

1100 36TH Ave
Moline, IL 61265-7127

Phone

(309) 743-6700

Fax

(309) 764-2042

NPI assigned

Jan 11, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Trinity Medical CenterGroup PAC ID 2264337518, 97 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Trinity Rock Island Hospital, Rock Island, IL, CCN 140280

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tjohnson88503@direct.unitypoint.org
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Trinity Medical Center

  • Emergency Medicine Physician
  • Rock Island, IL
  • NPI 1568414134
  Medicare reassignment Care Compare group
• Cardiovascular Medicine PLLC

  • Cardiovascular Disease Physician
  • Davenport, IA
  • NPI 1982632907

  IL

  Medicare reassignment NPD
• St Luke'S Methodist Hospital

  • General Acute Care Hospital
  • Cedar Rapids, IA
  • NPI 1083708226
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Trinity Medical Center

  • General Acute Care Hospital
  • Rock Island, IL
  • NPI 1316047632
  Care Compare affiliation

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

{
    "created_epoch": "1484092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613001600000",
    "number": "1194261479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1236 E RUSHOLME ST STE 300",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528032473",
            "telephone_number": "563-324-2992",
            "fax_number": "566-324-8562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 36TH AVE",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612657127",
            "telephone_number": "309-743-6700",
            "fax_number": "309-764-2042"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2701 17th St",
            "address_purpose": "LOCATION",
            "city": "Rock Island",
            "state": "IL",
            "postal_code": "612015351",
            "country_code": "US",
            "telephone_number": "309-779-5000",
            "fax_number": "309-779-2105",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "TARA",
        "middle_name": "L",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-11",
        "last_updated": "2021-02-11",
        "certification_date": "2021-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209015676",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "108072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tara.johnsonapn.p1@direct.cvmedpc.nextgenshare.com",
            "affiliation": "N",
            "address_1": "1100 36th Ave",
            "city": "Moline",
            "state": "IL",
            "country_code": "US",
            "postal_code": "612657127",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Brad Johnson
• Jennifer Robin Johnson
• John P Johnson, PA-C
• Sarah Elizabeth Johnson, CMA
• Suzanne Ellen Johnson, BCABA
• Tricia Sue Johnson, APN
• Allison Johnston, MHP
• Jessica L. Johnston, APN
• Nichole Marie Jones, NBC-HWC
• Sha'Miracle Jones

• Family Nurse Practitioner in Moline, IL
• Providers in Moline, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.