Individual provider Active NPI

Tara Marie Roberts, FNP-C

  • Family Nurse Practitioner
  • Camden, TN
National Provider Identifier
1477092864
Registry record updated Jan 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
22338 Issued in TN
Practice address
169 Briarwood St
Camden, TN 38320-1352
Phone
(731) 325-5231
Fax
(731) 506-1992
NPI assigned
Feb 17, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2023

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 22338 TN Primary

Addresses

Primary practice location

169 Briarwood St
Camden, TN 38320-1352

Mailing address

169 Briarwood St
Camden, TN 38320-1352
Phone (731) 325-5231

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20210517002492 TN Practitioner - Nurse Practitioner 1759790009 Reassigns benefits to 2 organizations

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
West Tennessee Medical Group IncGroup PAC ID 3971781006, 190 clinicians

Practice addresses (Care Compare)

620 Skyline Dr
Jackson, TN 38301-3923
Phone (731) 541-5000

Merit-based Incentive Payment System (MIPS)

Final score
95.74 of 100Reported as apm
Quality
85.23
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
22338TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
West Tennessee Medical Group Inc CurrentSince Apr 1, 2022 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince May 3, 2021 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince May 3, 2021 Accepting new patients

Locations

284 Highway 641 N
Camden, TN 38320
Phone (731) 213-2446

169 Briarwood St
Camden, TN 38320
Phone (731) 325-5231

620 Skyline Dr
Jackson, TN 38301
Phone (731) 541-4923

1804 Highway 45 Byp
Ste 604
Jackson, TN 38305
Phone (731) 512-1273

101 Jackson Walk Plz
Jackson, TN 38301
Phone (731) 421-6950

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": "1487289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673395200000",
    "number": "1477092864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 BRIARWOOD ST",
            "city": "CAMDEN",
            "state": "TN",
            "postal_code": "383201352",
            "telephone_number": "731-325-5231",
            "fax_number": "731-506-1992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 BRIARWOOD ST",
            "city": "CAMDEN",
            "state": "TN",
            "postal_code": "383201352",
            "telephone_number": "731-325-5231",
            "fax_number": "731-506-1992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "TARA",
        "middle_name": "MARIE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-17",
        "last_updated": "2023-01-11",
        "certification_date": "2021-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "22338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camden, TN

Sources for this page

Verify at the official NPI Registry.