Taryn Kline Fernandes, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

153791 Issued in FL

Practice address

163 11TH Ave
Union Grove, WI 53182-1282

Phone

(530) 356-6739

NPI assigned

Jun 14, 2017

Sex

Female

Sole proprietor

Yes

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.

• Eventus Ecs, Inc

  • Nurse Practitioner
  • Indianapolis, IN
  • NPI 1073353496

  IN, Internal Medicine

  Medicare reassignment Care Compare group NPD
• Complexcare Medical Group Midwest H PLLC

  • Internal Medicine Physician
  • Novi, MI
  • NPI 1457144933

  IN, Internal Medicine

  Medicare reassignment NPD
• Eventus Ecs - Kentucky, PLLC

  • Nurse Practitioner
  • Lexington, KY
  • NPI 1396563276

  IN, Internal Medicine

  Medicare reassignment NPD
• Eventus WH Midwest Care, LLC

  • Nurse Practitioner
  • Concord, NC
  • NPI 1588481717

  IN, Internal Medicine

  Medicare reassignment NPD
• Eventus Wholehealth Midwest Inc

  • Family Medicine Physician
  • Columbus, IN
  • NPI 1386252757

  IN, Internal Medicine

  Medicare reassignment NPD
• Extended Care Specialists, Inc

  • Adult Medicine Physician
  • Merrillville, IN
  • NPI 1134146079

  IN, Internal Medicine

  Medicare reassignment NPD
• Theoria Medical

  • Internal Medicine Physician
  • Novi, MI
  • NPI 1609362375

  IN, Internal Medicine

  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Adams County Memorial Hospital

  • Skilled Nursing Facility
  • Elkhart, IN
  • NPI 1023096138

  Nursing home

  Care Compare affiliation
• Community Hospital of Bremen, Inc

  • Critical Access Hospital
  • Bremen, IN
  • NPI 1568417004

  Hospital

  Care Compare affiliation
• Dunes Hospice LLC

  • Community Based Hospice Care Agency
  • Valparaiso, IN
  • NPI 1609280015

  Hospice

  Care Compare affiliation
• Major Hospital

  • Skilled Nursing Facility
  • Granger, IN
  • NPI 1164885372

  Nursing home

  Care Compare affiliation
• Paradigm Living Concepts, LLC

  • Community Based Hospice Care Agency
  • Indianapolis, IN
  • NPI 1407289119

  Hospice

  Care Compare affiliation
• The Health and Hospital Corporation of Marion County

  • Skilled Nursing Facility
  • South Bend, IN
  • NPI 1073869806

  Nursing home

  Care Compare affiliation
• The Health and Hospital Corporation of Marion County

  • Skilled Nursing Facility
  • Mishawaka, IN
  • NPI 1578809398

  Nursing home

  Care Compare affiliation
• Woodlawn Hospital

  • Nursing Facility/Intermediate Care Facility
  • New Carlisle, IN
  • NPI 1730174434

  Nursing home

  Care Compare affiliation

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Adams County Memorial Hospital

  • Skilled Nursing Facility
  • Elkhart, IN
  • NPI 1023096138

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Specialty

General Practice

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eventus Ecs, Inc 243 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Paradigm Health Hospice, Indianapolis, IN, CCN 151611
• Dunes Hospice LLC Hospice, Valparaiso, IN, CCN 151614
• Community Hospital of Bremen Inc Hospital, Bremen, IN, CCN 151300
• Belltower Health & Rehabilitation Center Nursing home, Granger, IN, CCN 155850
• Creekside Village Nursing home, Mishawaka, IN, CCN 155784
• Woodland Manor Nursing home, Elkhart, IN, CCN 155086
• Hamilton Grove Nursing home, New Carlisle, IN, CCN 155672
• Trailpoint Village Nursing home, South Bend, IN, CCN 155103

Medicare fee-for-service enrollment

Enrolled in FL, IN2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 20, 2021.

{
    "created_epoch": "1497398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1508396292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "163 11TH AVE",
            "city": "UNION GROVE",
            "state": "WI",
            "postal_code": "531821282",
            "telephone_number": "530-356-6739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "163 11TH AVE",
            "city": "UNION GROVE",
            "state": "WI",
            "postal_code": "531821282",
            "telephone_number": "530-356-6739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDES",
        "first_name": "TARYN",
        "middle_name": "KLINE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-14",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "153791",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125.071000",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Devries
• Drlullaby LLC
• Jenna Dundas
• Upali Elavia, DMD
• Allison Epping
• Kristin Fields
• Amanda Fontenot, DPT
• Gallina Health Care Network, LTD
• Michael Joseph Gillen, PH.D.
• Julie Ann Gotsch, CMHC- MS, LPC-IT

• All providers in Union Grove, WI
• General Practice Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.