Eileen Margaret Tague, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

5008641 Issued in NC

Practice address

2805 Lyndhurst Ave
Winston Salem, NC 27103-4109

Phone

(336) 659-0076

Fax

(336) 659-0272

NPI assigned

Jul 5, 2016

Last updated

Jul 5, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: eileen.tague.1@6378.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/6378/brand/1/csg/1/fhir/r4

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.

• Ardmore Family Practice P.a.

  • Family Medicine Physician
  • Winston Salem, NC
  • NPI 1750342820
  Medicare reassignment NPD

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

{
    "created_epoch": "1467676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467676800000",
    "number": "1558713370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2805 LYNDHURST AVE",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271034109",
            "telephone_number": "336-659-0076",
            "fax_number": "336-659-0272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2805 LYNDHURST AVE",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271034109",
            "telephone_number": "336-659-0076",
            "fax_number": "336-659-0272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAGUE",
        "first_name": "EILEEN",
        "middle_name": "MARGARET",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-05",
        "last_updated": "2016-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5008641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Sepe Tabili
• Sarah Anne Taekman, MD
• Charles Van Taft, M.D.
• Erin Tagge
• Gabriella Taghian
• Persida Tahiri, PHARMD
• Lauren Jane Tait
• Take My Hand Therapy, PLLC
• Ashley Lescanec Talbott
• Samantha Lynn Talbott, MD

• Nurse Practitioner in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.