Tara K Woodland, CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

9499 Issued in MN

Practice address

312 5TH Ave N
Bayport, MN 55003-1201

Phone

(651) 421-2914

NPI assigned

Mar 11, 2009

Last updated

Sep 30, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Sep 26, 2024 through Sep 26, 2026

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

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.

• Aimee Neumann Health and Wellness, LLC

  • Women's Health Nurse Practitioner
  • Shoreview, MN
  • NPI 1295415974

  Family

  NPD (past)
• Minnesota Vitality and Anti-Aging Center

  • Clinic/Center
  • Shoreview, MN
  • NPI 1598330219

  Family

  NPD (past)

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

{
    "created_epoch": "1236729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1629219233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 5TH AVE N",
            "city": "BAYPORT",
            "state": "MN",
            "postal_code": "550031201",
            "telephone_number": "651-421-2914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 5TH AVE N",
            "city": "BAYPORT",
            "state": "MN",
            "postal_code": "550031201",
            "telephone_number": "651-421-2914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODLAND",
        "first_name": "TARA",
        "middle_name": "K",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-11",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "R1735015",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "9499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Rae Schwartzbauer
• William B Shea, D.D.S.
• Cynthia Silva, RDN, LD
• Vitality Chiropractic, LLC
• David William Wieden, D.C.

• Family Nurse Practitioner in Bayport, MN
• Providers in Bayport, MN by specialty
• Family Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2024; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.