Tara Dawn Avriett, ARNP
Individual provider Active NPI Nurse Practitioner · Coeur D Alene, ID
NPI 1548022056 · NPPES record last updated Feb 19, 2024
Key facts
- NPI
- 1548022056
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 56241 (ID)
- Practice address
- 3815 N Schreiber Way Unit 102
Coeur D Alene, ID 83815-8434 - Phone
- (208) 667-4557
- Fax
- (208) 765-2887
- NPI assigned
- Jan 29, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Ironwood Family Practice, PA
Practice addresses (Care Compare)
3815 N Schreiber Way
Unit 102
Coeur D Alene, ID 83815-8434
Phone (208) 667-4557
Hospital & facility affiliations
- Kootenai Health
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240313001760 | ID | Practitioner - Nurse Practitioner | 3971949991 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 56241 | ID | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ironwood Family Practice, PA | Family Medicine | Current |
Accepting new patients |
Locations
3815 N Schreiber Way
Unit 102
Coeur D Alene, ID 83815
Phone (208) 667-4557
920 W Ironwood Dr
Ste 101
Coeur D Alene, ID 83814
Phone (208) 667-4557
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 56241 | ID | Yes |
Addresses
Primary practice location
3815 N Schreiber Way Unit 102
Coeur D Alene, ID 83815-8434
Mailing address
3815 N Schreiber Way Unit 102
Coeur D Alene, ID 83815-8434
Phone (208) 667-4557
Other providers in Coeur D Alene, ID
- Avanti Health LLC
- Ryan Kenneth Averett
- Joscelyn Averette
- Aviva Northwest, PLLC
- Lucinda L Avriett
- Stephen F Ayers
- B Beville and Associates, LLC
- Kathryn Ann Fabular Bacani
- Back in Health Chiropractic, Inc.
- Zachary Badger
All providers in Coeur D Alene, ID · Nurse Practitioner in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 19, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.