Individual provider Active NPI

Tara J. Robinson, PA-C

  • Medical Physician Assistant
  • Charleston, WV
National Provider Identifier
1508167867
Registry record updated Feb 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
1077 Issued in WV
Practice address
108 Washington St W Ste 101
Charleston, WV 25302-2344
Phone
(304) 345-4525
Fax
(304) 345-4527
NPI assigned
Nov 3, 2010
Last updated
Feb 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 1077 WV Primary
Procedural Dermatology Physician 207NS0135X 1077 WV

Addresses

Primary practice location

108 Washington St W Ste 101
Charleston, WV 25302-2344

Mailing address

108 Washington St W Ste 101
Charleston, WV 25302-2344
Phone (304) 345-4525

Other names 1

  • Tara J Chestnut Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20140811002037 WV Practitioner - Physician Assistant 7416900725 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
David J. Patton, MD., Inc.Group PAC ID 3577620277, 8 clinicians

Practice addresses (Care Compare)

108 Washington St W
Charleston, WV 25302-2344
Phone (304) 345-4525

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Greenbrier Clinic, Inc. CurrentSince May 15, 2014 Accepting new patients
Mountain Anesthesia, LLC Past Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1288742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707350400000",
    "number": "1508167867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 WASHINGTON ST W STE 101",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253022344",
            "telephone_number": "304-345-4525",
            "fax_number": "304-345-4527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 WASHINGTON ST W STE 101",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253022344",
            "telephone_number": "304-345-4525",
            "fax_number": "304-345-4527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBINSON",
        "first_name": "TARA",
        "middle_name": "J.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-03",
        "last_updated": "2024-02-08",
        "certification_date": "2024-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WV",
            "license": "1077",
            "primary": true
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "WV",
            "license": "1077",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TARA",
            "last_name": "CHESTNUT",
            "middle_name": "J",
            "credential": "P.A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.