Individual provider Active NPI

Tonnya Marie Taggart, FNP

  • Family Nurse Practitioner
  • Mountain Grove, MO
National Provider Identifier
1619332608
Registry record updated Jun 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2017006199 Issued in MO
Practice address
120 W 16TH St
Mountain Grove, MO 65711-1039
Phone
(417) 926-6111
NPI assigned
Dec 18, 2015
Last updated
Jun 24, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95003540 CA
Family Nurse Practitioner 363LF0000X 2017006199 MO Primary

Addresses

Primary practice location

120 W 16TH St
Mountain Grove, MO 65711-1039

Mailing address

120 W 16TH St
Mountain Grove, MO 65711-1039
Phone (417) 926-6111

Other practice location 1

12345 Saint Charles Rock Rd
Bridgeton, MO 63044-2505
Phone (844) 776-7200

Other practice location 2

12345 Saint Charles Rock Rd
Bridgeton, MO 63044-2505
Phone (844) 776-7200

Other practice location 3

638 Camino De Los Mares
San Clemente, CA 92673-2848
Phone (866) 389-2727

Other practice location 4

16555 Manchester Rd Ste 100
Wildwood, MO 63040-1220
Phone (636) 458-0646

Other practice location 5

16555 Manchester Rd Ste 110
Wildwood, MO 63040
Phone (636) 405-3155

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95003540CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic East Communities Past Accepting new patients
Ozarks Medical Center Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1450396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624492800000",
    "number": "1619332608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 W 16TH ST",
            "city": "MOUNTAIN GROVE",
            "state": "MO",
            "postal_code": "657111039",
            "telephone_number": "417-926-6111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 W 16TH ST",
            "city": "MOUNTAIN GROVE",
            "state": "MO",
            "postal_code": "657111039",
            "telephone_number": "417-926-6111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12345 Saint Charles Rock Rd",
            "address_purpose": "LOCATION",
            "city": "Bridgeton",
            "state": "MO",
            "postal_code": "630442505",
            "country_code": "US",
            "telephone_number": "844-776-7200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12345 Saint Charles Rock Rd",
            "address_purpose": "LOCATION",
            "city": "Bridgeton",
            "state": "MO",
            "postal_code": "630442505",
            "country_code": "US",
            "telephone_number": "844-776-7200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "638 Camino De Los Mares",
            "address_purpose": "LOCATION",
            "city": "San Clemente",
            "state": "CA",
            "postal_code": "926732848",
            "country_code": "US",
            "telephone_number": "866-389-2727",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16555 Manchester Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Wildwood",
            "state": "MO",
            "postal_code": "630401220",
            "country_code": "US",
            "telephone_number": "636-458-0646",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16555 Manchester Rd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Wildwood",
            "state": "MO",
            "postal_code": "63040",
            "country_code": "US",
            "telephone_number": "636-405-3155",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAGGART",
        "first_name": "TONNYA",
        "middle_name": "MARIE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-18",
        "last_updated": "2021-06-24",
        "certification_date": "2021-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95003540",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2017006199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain Grove, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.