Individual provider Active NPI

Tara Keith

  • Gerontology Nurse Practitioner
  • Roanoke, VA
National Provider Identifier
1407396542
Registry record updated Nov 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
0024174587 Issued in VA
Practice address
3 Riverside Cir
Roanoke, VA 24016-4955
Phone
(540) 224-5170
NPI assigned
Mar 7, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 11, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 0024174587 VA
Gerontology Nurse Practitioner 363LG0600X 0024174587 VA Primary
Adult Health Nurse Practitioner 363LA2200X 0024174587 VA

Addresses

Primary practice location

3 Riverside Cir
Roanoke, VA 24016-4955

Mailing address

213 S Jefferson St Ste 1006
Roanoke, VA 24011-1713

Other practice location 1

1900 Electric Rd
Salem, VA 24153-7474
Phone (540) 776-4000

Other practice location 2

2001 Crystal Spring Ave SW
Roanoke, VA 24014-2462
Phone (540) 981-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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

Enrollment IDStateProvider typePAC IDDetails
I20170818001264 VA Practitioner - Nurse Practitioner 2860763083 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carilion Medical CenterGroup PAC ID 9830096585, 956 clinicians

Practice addresses (Care Compare)

1906 Belleview Ave SE
Roanoke, VA 24014-1838
Phone (540) 981-7000

2017 Jefferson St SW
Roanoke, VA 24014-2419
Phone (540) 981-7925

2017 S Jefferson St
Roanoke, VA 24014-2419
Phone (540) 981-7128

3 Riverside Cir
Roanoke, VA 24016-4955
Phone (540) 224-5170

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.16 of 100Reported as apm
Quality
83.58
Promoting interoperability
94
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0024174587VAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carilion Medical Center CurrentSince Oct 5, 2024 Accepting new patients
Carilion Medical Center CurrentSince Oct 5, 2024 Accepting new patients
Carilion Medical Center Past Accepting new patients

Locations

1901 Tate Springs Rd
Lynchburg, VA 24501
Phone (434) 200-3101

2017 Jefferson St SW
Roanoke, VA 24014
Phone (540) 981-7128

3 Riverside Cir
Roanoke, VA 24016

2001 Crystal Spring Ave SW
Roanoke, VA 24014
Phone (540) 344-5781

213 S Jefferson St
Ste 1006
Roanoke, VA 24011
Phone (540) 224-5353

1900 Electric Rd
Salem, VA 24153
Phone (540) 772-3400

Interoperability endpoints

  • Direct secure messaging: tkeith188875@direct.carilionclinic.org

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1488844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762819200000",
    "number": "1407396542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 S JEFFERSON ST STE 1006",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240111713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 RIVERSIDE CIR",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240164955",
            "telephone_number": "540-224-5170"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1900 Electric Rd",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "VA",
            "postal_code": "241537474",
            "country_code": "US",
            "telephone_number": "540-776-4000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2001 Crystal Spring Ave SW",
            "address_purpose": "LOCATION",
            "city": "Roanoke",
            "state": "VA",
            "postal_code": "240142462",
            "country_code": "US",
            "telephone_number": "540-981-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEITH",
        "first_name": "TARA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-07",
        "last_updated": "2025-11-11",
        "certification_date": "2025-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "VA",
            "license": "0024174587",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "VA",
            "license": "0024174587",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "VA",
            "license": "0024174587",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.