Individual provider Active NPI

Tara S. Perdue, APRN

  • Family Nurse Practitioner
  • Franklin, KY
National Provider Identifier
1639280985
Registry record updated Apr 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3003086 Issued in KY
Practice address
119 Memorial Dr
Franklin, KY 42134-2752
Phone
(270) 586-9533
Fax
(270) 586-0123
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 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 3003086 KY Primary

Addresses

Primary practice location

119 Memorial Dr
Franklin, KY 42134-2752

Mailing address

201 Park St
Bowling Green, KY 42101-1759
Phone (270) 586-9533

Other identifiers 1

IdentifierTypeStateIssuer
78003217MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20040217000000 KY Practitioner - Nurse Practitioner 9739074014 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Graves Gilbert Clinic PLLCGroup PAC ID 4082511167, 207 clinicians

Practice addresses (Care Compare)

201 Park St
Bowling Green, KY 42101-1742
Phone (270) 781-5111

2724 Nashville Rd
Bowling Green, KY 42101-4000
Phone 2707815111270

Hospital & facility affiliations

  • Lifeline Health Care of Warren Home health agency, Bowling Green, KY, CCN 187080
  • Family Home Health Care, LLC Dba Adoration Home Health Home health agency, Columbia, KY, CCN 187119
  • The Medical Center at Franklin Hospital, Franklin, KY, CCN 181318
  • The Medical Center (Bowling Green) Hospital, Bowling Green, KY, CCN 180013

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Graves Gilbert Clinic PLLC CurrentSince Jun 1, 2018 Accepting new patients
Graves Gilbert Clinic PLLC CurrentSince Jun 1, 2018 Accepting new patients

Locations

1225 Fairway St
Bowling Green, KY 42103
Phone (270) 781-3910

201 Park St
Bowling Green, KY 42101
Phone (270) 651-2229

119 Memorial Dr
Franklin, KY 42134
Phone (270) 586-9533

1030 Brookhaven Rd
Franklin, KY 42134
Phone (270) 586-1800

1112 S Main St
Franklin, KY 42134
Phone (270) 586-1969

Interoperability endpoints

  • Direct secure messaging: taraperdue@ggc.allscriptsdirect.net

Organizations & group practices 5

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 4

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523923200000",
    "number": "1639280985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 PARK ST",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421011759",
            "telephone_number": "270-586-9533",
            "fax_number": "270-586-0123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 MEMORIAL DR",
            "city": "FRANKLIN",
            "state": "KY",
            "postal_code": "421342752",
            "telephone_number": "270-586-9533",
            "fax_number": "270-586-0123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERDUE",
        "first_name": "TARA",
        "middle_name": "S.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2018-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3003086",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "78003217",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Franklin, KY

Sources for this page

Verify at the official NPI Registry.