Individual provider Active NPI

Tara Ford

  • Family Nurse Practitioner
  • Owensboro, KY
National Provider Identifier
1538925573
Registry record updated Feb 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4016626 Issued in KY
Practice address
1205 Leitchfield Rd
Owensboro, KY 42303-0861
Phone
(731) 394-1145
NPI assigned
Feb 27, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2024

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 4016626 KY Primary

Addresses

Primary practice location

1205 Leitchfield Rd
Owensboro, KY 42303-0861

Mailing address

2725 Frederica St
Owensboro, KY 42301-5443
Phone (270) 302-9182

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20240318001528 KY Practitioner - Nurse Practitioner 4486091105 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ultra Health LLCGroup PAC ID 6800186602, 151 clinicians
Pineville Community Health Center IncGroup PAC ID 5698009157, shared by 4 NPIs, 39 clinicians

Practice addresses (Care Compare)

718 Goodwin LN
Leitchfield, KY 42754-1400
Phone (731) 394-1145

850 Riverview Ave
Pineville, KY 40977-1452
Phone 6063373051251

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4016626KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ultra Health Providers III LLC CurrentSince Jan 5, 2026 Accepting new patients
Ultra Health LLC CurrentSince Feb 29, 2024 Accepting new patients

Locations

366 S Washington St
Clinton, KY 42031
Phone (270) 653-2461

718 Goodwin Ln
Leitchfield, KY 42754
Phone (270) 259-3676

1205 Leitchfield Rd
Owensboro, KY 42303
Phone (270) 314-3668

850 Riverview Ave
Pineville, KY 40977
Phone (606) 337-3051

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14578/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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": "1708992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708992000000",
    "number": "1538925573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2725 FREDERICA ST",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423015443",
            "telephone_number": "270-302-9182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 LEITCHFIELD RD",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423030861",
            "telephone_number": "731-394-1145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORD",
        "first_name": "TARA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-27",
        "last_updated": "2024-02-27",
        "certification_date": "2024-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "4016626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Owensboro, KY

Sources for this page

Verify at the official NPI Registry.