Tara Lynn Pettit, CRNA, MSN

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

NJ00305300 Issued in NJ

Practice address

1 Cooper PLZ
Camden, NJ 08103-1461

Phone

(856) 342-2425

NPI assigned

Jun 1, 2010

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

Other identifiers 1

Other names 1

• Ms. Tara Lynn Legates Former name

Medicare fee-for-service enrollment

Enrolled in NJ, PA2 enrollments

Enrollment records 2

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Parkway Anesthesia Associates LLCGroup PAC ID 2567758931, 313 clinicians

Ultracare Anesthesia Partners LLCGroup PAC ID 4082920525, 78 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Inspira Medical Center Mullica Hill Hospital, Elmer, NJ, CCN 310069

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing

State licenses

Practice roles

Locations

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.

• Parkway Anesthesia Associates LLC

  • Anesthesiology Physician
  • North Bergen, NJ
  • NPI 1518319755
  Medicare reassignment Care Compare group NPD
• Ultracare Anesthesia Partners LLC

  • Anesthesiology Physician
  • Philadelphia, PA
  • NPI 1407236110

  NJ, Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• CHC Pain Management Center, PA

  • Pain Medicine (Anesthesiology) Physician
  • Camden, NJ
  • NPI 1538109913
  Medicare reassignment
• Cooper Anesthesia Associates, PC

  • Anesthesiology Physician
  • Camden, NJ
  • NPI 1447207147
  Medicare reassignment
• North American Partners in Anesthesia of New Jersey LLC

  • Anesthesiology Physician
  • Brick, NJ
  • NPI 1548433048
  NPD
• GSC Anesthesia

  • Certified Registered Nurse Anesthetist
  • Philadelphia, PA
  • NPI 1134718885

  Nurse Anesthetist, Certified Registered

  NPD
• Grant Surgicenter LLC

  • Ambulatory Surgical Clinic/Center
  • Philadelphia, PA
  • NPI 1194027920
  NPD (past)

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

• Inspira Medical Centers, Inc.

  • General Acute Care Hospital
  • Elmer, NJ
  • NPI 1255396024
  Care Compare affiliation
• Inspira Medical Centers, Inc.

  • General Acute Care Hospital
  • Mullica Hill, NJ
  • NPI 1366097032
  Care Compare affiliation
• South Jersey Hospital, Inc.

  • Physical Therapy Clinic/Center
  • Mullica Hill, NJ
  • NPI 1609158732

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1275350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523404800000",
    "number": "1205155223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FEDERAL ST STE SW200",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031155",
            "telephone_number": "856-356-4924",
            "fax_number": "856-356-4710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 COOPER PLZ",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031461",
            "telephone_number": "856-342-2425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTIT",
        "first_name": "TARA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "CRNA, MSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-01",
        "last_updated": "2018-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NJ",
            "license": "26NR11265000",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NJ",
            "license": "NJ00305300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "NJ00305300",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TARA",
            "last_name": "LEGATES",
            "middle_name": "LYNN",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jennifer F Peterson, LSW
• Lars-Kristofer Nelson Peterson, MD
• Jenni Elizabeth M. Petrella, DO
• Matthew George Petruncio, MD
• Nina Casella Petruzzi, PA-C
• Dung Kim Pham, CRNA
• Lee Kim Phan, PHARMD
• Phung Kim Phan, PHARM.D.
• Amanda Phelan, NP
• Philadelphia Vamc

• Certified Registered Nurse Anesthetist in Camden, NJ
• Providers in Camden, NJ by specialty
• Certified Registered Nurse Anesthetist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.