Individual provider Active NPI

Tara Fenner, FNP-C

  • Family Nurse Practitioner
  • Groves, TX
National Provider Identifier
1417423153
Registry record updated Jan 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP140593 Issued in TX
Practice address
6265 39TH St
Groves, TX 77619-4614
Phone
(409) 962-4400
Fax
(409) 962-4412
NPI assigned
Oct 20, 2018
Last updated
Jan 19, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2026

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 AP140593 TX Primary

Addresses

Primary practice location

6265 39TH St
Groves, TX 77619-4614

Mailing address

6000 39TH St
Groves, TX 77619-4600
Phone (409) 962-8509

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20190613002907 TX Practitioner - Nurse Practitioner 3072846682 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lacomb Health and Wellness, PLLCGroup PAC ID 5698024438, 3 clinicians
Roussel Clement MD PAGroup PAC ID 4486655446, 2 clinicians

Practice addresses (Care Compare)

6000 39TH St
Groves, TX 77619-4600
Phone (409) 962-8509

6265 39TH St
Groves, TX 77619-4614
Phone (409) 962-4400

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lacomb Health & Wellness, PLLC Family CurrentSince Dec 15, 2025 Accepting new patients
Russell N. McDonald PastSince Dec 15, 2025 Accepting new patients

Locations

6000 39th St
Groves, TX 77619
Phone (409) 962-4446

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1539993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768780800000",
    "number": "1417423153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6000 39TH ST",
            "city": "GROVES",
            "state": "TX",
            "postal_code": "776194600",
            "telephone_number": "409-962-8509",
            "fax_number": "409-962-0763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6265 39TH ST",
            "city": "GROVES",
            "state": "TX",
            "postal_code": "776194614",
            "telephone_number": "409-962-4400",
            "fax_number": "409-962-4412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENNER",
        "first_name": "TARA",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-20",
        "last_updated": "2026-01-19",
        "certification_date": "2026-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP140593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Groves, TX

Sources for this page

Verify at the official NPI Registry.