Active NPI
Taryn Graves
- Registered Nurse
- Santa Rosa, CA
National Provider Identifier
1275245656
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 743145
- Practice address
- 401 Bicentennial Way
Santa Rosa, CA 95403-2149 - Phone
- (707) 393-4800
- NPI assigned
- Dec 19, 2022
- 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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 743145 | CA | Primary |
Addresses
Primary practice location
401 Bicentennial Way
Santa Rosa, CA 95403-2149
Mailing address
474 Walten Way
Windsor, CA 95492-7931
Phone (707) 322-1021
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 743145 | Other | CA | CALIFORNIA BOARD OF REGISTERED NURSING |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | taryn.t.graves@kp.org | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 743145 | CA | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1671408000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1671408000000",
"number": "1275245656",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "474 WALTEN WAY",
"city": "WINDSOR",
"state": "CA",
"postal_code": "954927931",
"telephone_number": "707-322-1021"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 BICENTENNIAL WAY",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954032149",
"telephone_number": "707-393-4800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAVES",
"first_name": "TARYN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-12-19",
"last_updated": "2022-12-19",
"certification_date": "2022-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "CA",
"license": "743145",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CALIFORNIA BOARD OF REGISTERED NURSING",
"identifier": "743145",
"state": "CA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "taryn.t.graves@kp.org",
"affiliation": "N",
"endpointDescription": "Nursing Email",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Text",
"address_1": "401 Bicentennial Way",
"city": "Santa Rosa",
"state": "CA",
"country_code": "US",
"postal_code": "954032149",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Santa Rosa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.