Individual provider Active NPI

Tara Leann Green, APRN, FNP-C

  • Family Nurse Practitioner
  • Rogers, AR
National Provider Identifier
1598272866
Registry record updated Mar 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
A005447 Issued in AR
Practice address
613 N 2ND St
Rogers, AR 72756-6611
Phone
(479) 878-1060
NPI assigned
Jan 8, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2018

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 A005447 AR Primary

Addresses

Primary practice location

613 N 2ND St
Rogers, AR 72756-6611

Mailing address

613 N 2ND St
Rogers, AR 72756-6611
Phone (479) 878-1060

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20180302001331 AR Practitioner - Nurse Practitioner 7618238866 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

613 N 2ND St
Rogers, AR 72756-6611
Phone (479) 878-1060

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
A005447ARMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Northwest Arkansas Communities Current Accepting new patients
Mercy Health Northwest Arkansas Communities CurrentSince Feb 12, 2018 Accepting new patients
Mercy Health Northwest Arkansas Communities CurrentSince Feb 12, 2018 Accepting new patients

Locations

1 Mercy Way
Ste 20
Bella Vista, AR 72714
Phone (479) 802-5555

1 Mercy Way
Bella Vista, AR 72714
Phone (479) 802-5555

3101 SE 14th St
Bentonville, AR 72712
Phone (479) 631-2100

2708 S Rife Medical Ln
Ste T30
Rogers, AR 72758
Phone (479) 338-3999

613 N 2nd St
Rogers, AR 72756
Phone (479) 787-1060

Interoperability endpoints

  • Direct secure messaging: tgreen974436@directc.mercy.net

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1515369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520294400000",
    "number": "1598272866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "613 N 2ND ST",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727566611",
            "telephone_number": "479-878-1060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "613 N 2ND ST",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727566611",
            "telephone_number": "479-878-1060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "TARA",
        "middle_name": "LEANN",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-08",
        "last_updated": "2018-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A005447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rogers, AR

Sources for this page

Verify at the official NPI Registry.