Individual provider Active NPI

Tara M Henagan, MD, PHD

  • Family Medicine Physician
  • Baton Rouge, LA
National Provider Identifier
1649911181
Registry record updated Jan 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
338848 Issued in LA
Practice address
3401 North Blvd Ste 200
Baton Rouge, LA 70806-3743
Phone
(225) 381-6620
NPI assigned
Apr 6, 2022
Last updated
Jan 23, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 338848 LA Primary

Addresses

Primary practice location

3401 North Blvd Ste 200
Baton Rouge, LA 70806-3743

Mailing address

3401 North Blvd Ste 200
Baton Rouge, LA 70806-3743
Phone (225) 381-6620

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241125002249 LA Practitioner - Family Practice 7618413998 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Louisiana State University School of Medicine in Shreveport, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Crowley Emergency Group LLCGroup PAC ID 1456572965, 26 clinicians
St Martin Emergency Group LLCGroup PAC ID 0840444683, 20 clinicians

Practice addresses (Care Compare)

1305 Crowley Rayne Hwy
Crowley, LA 70526-8202
Phone (337) 783-3222

210 Champagne Blvd
Breaux Bridge, LA 70517-3700
Phone (337) 332-2178

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
338848LAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Crowley Emergency Group LLC CurrentSince Jul 1, 2025 Accepting new patients
Signify Health, LLC CurrentSince Jan 1, 2026 Accepting new patients
St Martin Emergency Group LLC CurrentSince Oct 13, 2024 Accepting new patients
Professional Emergency Physician Associates, LLC CurrentSince Nov 1, 2025 Accepting new patients

Locations

Dept AT952639
Atlanta, GA 31192

5000 Hennessy Blvd
Baton Rouge, LA 70808
Phone (225) 765-4050

210 Champagne Blvd
Breaux Bridge, LA 70517
Phone (337) 332-2178

1305 E Highway 90
Crowley, LA 70526
Phone (337) 783-3222

200 Corporate Blvd
Lafayette, LA 70508

201 Saint Charles Ave
Ste 2500
New Orleans, LA 70170
Phone (504) 224-6402

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Interoperability endpoints

  • Direct secure messaging: thenagan4880570@direct.casso.us.com

Organizations & group practices 4

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.

Hospital & facility affiliations 3

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": "1649203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737590400000",
    "number": "1649911181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 NORTH BLVD STE 200",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708063743",
            "telephone_number": "225-381-6620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 NORTH BLVD STE 200",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708063743",
            "telephone_number": "225-381-6620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENAGAN",
        "first_name": "TARA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-06",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "338848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.