Tara Sue Vangundy, CFNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

COA13396 Issued in OH

Practice address

1110 Oakwood Ave
Oakwood, OH 45419-2911

Phone

(937) 885-7163

Fax

(937) 567-0670

NPI assigned

Jul 19, 2012

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

Other identifiers 1

Other names 1

• Tara Sue Ray Other name

Medicare fee-for-service enrollment

Enrolled in OH

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

University of Cincinnati College of Medicine, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Comprehensive Geriatric Care, LLCGroup PAC ID 3476642901, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/kavrecovery/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.

• Comprehensive Geriatric Care, LLC

  • Geriatric Medicine (Family Medicine) Physician
  • Oakwood, OH
  • NPI 1598945230
  Medicare reassignment Care Compare group NPD
• Kav Health Group LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Dayton, OH
  • NPI 1891332946
  Medicare reassignment NPD
• Valley Medical Primary Care, Inc

  • Geriatric Medicine (Internal Medicine) Physician
  • Centerville, OH
  • NPI 1528127610
  Medicare reassignment NPD
• Kav Health Group, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Dayton, OH
  • NPI 1255978300
  NPD
• Valley Medical LTC Inc

  • Geriatric Medicine (Internal Medicine) Physician
  • Centerville, OH
  • NPI 1306632708
  NPD (past)

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

{
    "created_epoch": "1342656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739318400000",
    "number": "1295080851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7073 CLYO RD",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "454594816",
            "telephone_number": "937-435-5857",
            "fax_number": "937-912-4960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 OAKWOOD AVE",
            "city": "OAKWOOD",
            "state": "OH",
            "postal_code": "454192911",
            "telephone_number": "937-885-7163",
            "fax_number": "937-567-0670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANGUNDY",
        "first_name": "TARA",
        "middle_name": "SUE",
        "credential": "CFNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-19",
        "last_updated": "2025-02-12",
        "certification_date": "2025-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "COA13396",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0068897",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TARA",
            "last_name": "RAY",
            "middle_name": "SUE",
            "credential": "RN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Danielle Nicole Snyder, D.C.
• Sober Nation LLC
• Ethan M Sullivan, DPT
• Katheryn Rose Talcott, MS, RD, CDE, LD
• Heather Tutt-Robinson, LMT
• Jithin Vijayan, MA, LPCC
• Village of Oakwood
• Adam Logan Vorlicky
• Jonathon Walton
• Jeffrey J Witwer, LISW-SUPV

• Family Nurse Practitioner in Oakwood, OH
• Providers in Oakwood, OH by specialty
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2025; 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.