Tara Anderson, L.AC., FABORM

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

201642 Issued in OR

Practice address

235 W D St
Jacksonville, OR 97530-0038

Phone

(541) 838-0980

NPI assigned

Jan 5, 2016

Sex

Female

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Not enrolled

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 and National Provider Directory roles.

• Fertile Spring, LLC

  • Acupuncturist
  • Jacksonville, OR
  • NPI 1790518124
  NPD Authorized official
• Santa Cruz Natural Medicine

  • Acupuncturist
  • Santa Cruz, CA
  • NPI 1659815595
  NPD (past) Authorized official

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

{
    "created_epoch": "1451952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724198400000",
    "number": "1649636788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 895",
            "city": "JACKSONVILLE",
            "state": "OR",
            "postal_code": "975300895",
            "telephone_number": "541-838-0980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 W D ST",
            "city": "JACKSONVILLE",
            "state": "OR",
            "postal_code": "975300038",
            "telephone_number": "541-838-0980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "TARA",
        "credential": "L.AC., FABORM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-05",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "16394",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "201642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jordyn Airrington
• Applegate Valley Dental Inc
• Applegate Valley Dental Inc
• Applegate Valley Dental, Inc.
• Autumn D Mercer Agnp-C LLC
• Deborah Luetkenhoelter Benson, M.A./CCC-SLP

• Acupuncturist in Jacksonville, OR
• Providers in Jacksonville, OR by specialty
• Acupuncturist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2024; 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.