Individual provider Active NPI

Tara Schroeder, CNP

  • Family Nurse Practitioner
  • Scottsdale, AZ
National Provider Identifier
1437630878
Registry record updated Jul 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.023212 Issued in OH
Practice address
9201 E Mountain View Rd
Scottsdale, AZ 85258
Phone
(877) 564-3627
NPI assigned
Aug 23, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2019

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 APRN.CNP.023212 OH Primary

Addresses

Primary practice location

9201 E Mountain View Rd
Scottsdale, AZ 85258

Mailing address

4055 Valley View LN
Dallas, TX 75244-5074
Phone (972) 715-3800

Other practice location 1

4055 Valley View Ln
Dallas, TX 75244
Phone (972) 715-3800

Other practice location 2

4055 Valley View Ln
Dallas, TX 75244
Phone (972) 715-3800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20181003001822 OH Practitioner - Nurse Practitioner 9436401312 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN.CNP.023212OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Incare Health Solutions LLC CurrentSince Oct 15, 2018 Accepting new patients
Incare Health Solutions, LLC Family CurrentSince Oct 15, 2018 Accepting new patients

Locations

1341 S Trimble Rd
Mansfield, OH 44907
Phone (419) 775-7807

7450 State Route 161 E
Plain City, OH 43064
Phone (614) 504-5002

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.

NPI Registry JSON

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

{
    "created_epoch": "1534982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562889600000",
    "number": "1437630878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4055 VALLEY VIEW LN",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752445074",
            "telephone_number": "972-715-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9201 E MOUNTAIN VIEW RD",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "85258",
            "telephone_number": "877-564-3627"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4055 Valley View Ln",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "75244",
            "country_code": "US",
            "telephone_number": "972-715-3800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4055 Valley View Ln",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "75244",
            "country_code": "US",
            "telephone_number": "972-715-3800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHROEDER",
        "first_name": "TARA",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-23",
        "last_updated": "2019-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.023212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.