Stacia J Taverner

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

1300 Main St
Windsor, CO 80550-5989

Phone

(970) 810-5498

Fax

(970) 810-5459

NPI assigned

Dec 6, 2007

Last updated

Sep 19, 2022By 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

Medicare fee-for-service enrollment

Enrolled in CO

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

Mental Health Counselor

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Banner Health Physicians Colorado LLCGroup PAC ID 8921273038, 278 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Banner Health Physicians Colorado LLC

  • Multi-Specialty Clinic/Center
  • Greeley, CO
  • NPI 1073899134
  Medicare reassignment Care Compare group NPD
• Banner Health Physicians Colorado LLC

  • Multi-Specialty Clinic/Center
  • Torrington, WY
  • NPI 1215375688
  NPD

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

{
    "created_epoch": "1196899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663545600000",
    "number": "1467635086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 MAIN ST",
            "city": "WINDSOR",
            "state": "CO",
            "postal_code": "805505989",
            "telephone_number": "970-481-7944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 MAIN ST",
            "city": "WINDSOR",
            "state": "CO",
            "postal_code": "805505989",
            "telephone_number": "970-810-5498",
            "fax_number": "970-810-5459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAVERNER",
        "first_name": "STACIA",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-06",
        "last_updated": "2022-09-19",
        "certification_date": "2022-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sophie McLean Supernor
• Laura A Sutherlin, P.T.
• Jennie Szabo, COTA/L
• Tanner Autism Services of Colorado (Tasc)
• Karson Lynnelle Taulbee, PT, DPT
• TCPS Enterprises LLC (Tender Care Pediatric Services)
• Tender Hearts Home Healthcare, LLC
• Tender Hearts Home Healthcare, LLC
• Jordin Eileen Terry
• The Otero Corporation

• Counselor in Windsor, CO
• Providers in Windsor, CO by specialty
• Counselor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2022; 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.