Individual provider Active NPI

Tara Johnson Pabis, APRN

  • Family Nurse Practitioner
  • Dothan, AL
National Provider Identifier
1396586822
Registry record updated Aug 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-120710 Issued in AL
Practice address
2870 Montgomery Hwy
Dothan, AL 36303-2606
Phone
(334) 500-5500
Fax
(334) 500-5550
NPI assigned
Jun 6, 2024
Last updated
Aug 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1-120710 AL Primary

Addresses

Primary practice location

2870 Montgomery Hwy
Dothan, AL 36303-2606

Mailing address

4719 Highway 90
Marianna, FL 32446-7839
Phone (850) 526-3314

Other practice location 1

4719 Highway 90
Marianna, FL 32446-7839
Phone (850) 526-3314

Other names 1

  • Tara Suzannah Johnson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, AL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240918004824 FL Practitioner - Nurse Practitioner 8325589229 Reassigns benefits to 4 organizations
I20250221002250 AL Practitioner - Nurse Practitioner 8325589229 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1-120710ALMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Caremed Clinic LLC Family CurrentSince Sep 10, 2024 Accepting new patients
Caremed Clinic - Alabama LLC Family CurrentSince Mar 1, 2025 Accepting new patients
Caremed Weight Loss - Alabama LLC Family CurrentSince Mar 1, 2025 Accepting new patients
Caremed Urgent Care LLC Family CurrentSince Sep 10, 2024 Accepting new patients
Caremed Urgent Care - Alabama LLC CurrentSince Mar 1, 2025 Accepting new patients

Locations

2870 Montgomery Hwy
Dothan, AL 36303
Phone (334) 500-5500

951 Prim Ave
Ste 20
Graceville, FL 32440
Phone (850) 360-4000

4719 Highway 90
Marianna, FL 32446
Phone (850) 526-3314

Interoperability endpoints

  • Direct secure messaging: tara.johnson.1@20680.direct.athenahealth.com

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1717632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755734400000",
    "number": "1396586822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4719 HIGHWAY 90",
            "city": "MARIANNA",
            "state": "FL",
            "postal_code": "324467839",
            "telephone_number": "850-526-3314",
            "fax_number": "850-526-5022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2870 MONTGOMERY HWY",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363032606",
            "telephone_number": "334-500-5500",
            "fax_number": "334-500-5550"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4719 Highway 90",
            "address_purpose": "LOCATION",
            "city": "Marianna",
            "state": "FL",
            "postal_code": "324467839",
            "country_code": "US",
            "telephone_number": "850-526-3314",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PABIS",
        "first_name": "TARA",
        "middle_name": "JOHNSON",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-06",
        "last_updated": "2025-08-21",
        "certification_date": "2025-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-120710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TARA",
            "last_name": "JOHNSON",
            "middle_name": "SUZANNAH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dothan, AL

Sources for this page

Verify at the official NPI Registry.