Tara Jean Bosnic, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

007613 Issued in IA

Practice address

2300 Swan Lake Blvd Ste 102
Independence, IA 50644-9708

Phone

(563) 579-1181

NPI assigned

Nov 9, 2010

Last updated

Mar 17, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Tara Jean Nissen Former name

Medicare fee-for-service enrollment

Enrolled in IA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Emerald Bridges Family Therapy, LLC

  • Clinical Social Worker
  • Independence, IA
  • NPI 1073966123
  Medicare reassignment NPD

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

{
    "created_epoch": "1289260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1417258351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 SWAN LAKE BLVD STE 102",
            "city": "INDEPENDENCE",
            "state": "IA",
            "postal_code": "506449708",
            "telephone_number": "563-579-1181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 SWAN LAKE BLVD STE 102",
            "city": "INDEPENDENCE",
            "state": "IA",
            "postal_code": "506449708",
            "telephone_number": "563-579-1181"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2277 Iowa Ave",
            "address_purpose": "LOCATION",
            "city": "Independence",
            "state": "IA",
            "postal_code": "506449106",
            "country_code": "US",
            "telephone_number": "563-579-1181",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOSNIC",
        "first_name": "TARA",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-09",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "007613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TARA",
            "last_name": "NISSEN",
            "middle_name": "JEAN",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rachel Ballard
• Amanda Becker, LMSW
• Katherine Bell
• Katelyn Beres, MOTR/L
• Amy Blanchard
• Bradley Boyle, O.D.
• Seth A Brown, PH.D.
• Buchanan County Case Management
• Carrie MM Kearns, OD/PC (Advanced Family Eye Care)
• Courtney Marie Carter, PHARMD, RPH

• Clinical Social Worker in Independence, IA
• Providers in Independence, IA by specialty
• Clinical Social Worker in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.