NPIMap

Individual provider Active NPI

Tara M Wilson, CFA

  • Surgical Assistant
  • Carmel, IN
National Provider Identifier
1386886620
Registry record updated Jun 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical AssistantTaxonomy code 246ZC0007X
License
113533 Issued in IN
Practice address
13430 N Meridian St
Suite 275
Carmel, IN 46032-1405
Phone
(317) 582-8810
Fax
(317) 582-8863
NPI assigned
Apr 1, 2009
Last updated
Jun 22, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Assistant 246ZC0007X 113533 IN Primary

Addresses

Primary practice location

13430 N Meridian St
Suite 275
Carmel, IN 46032-1405

Mailing address

13430 N Meridian St
Suite 275
Carmel, IN 46032-1405
Phone (317) 582-8810

Other identifiers 1

IdentifierTypeStateIssuer
113533OtherINCFA

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

LicenseStateTypeSpecialty
113533INMDSurgical Assistant

NPI Registry JSON

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

{
    "created_epoch": "1238544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308700800000",
    "number": "1386886620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13430 N MERIDIAN ST",
            "address_2": "SUITE 275",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460321405",
            "telephone_number": "317-582-8810",
            "fax_number": "317-582-8863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13430 N MERIDIAN ST",
            "address_2": "SUITE 275",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460321405",
            "telephone_number": "317-582-8810",
            "fax_number": "317-582-8863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "TARA",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "CFA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-01",
        "last_updated": "2011-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "IN",
            "license": "113533",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CFA",
            "identifier": "113533",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carmel, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.