NPIMap

Individual provider Active NPI

Tarah Sellner, FNP-C

  • Family Nurse Practitioner
  • Pueblo, CO
National Provider Identifier
1659865533
Registry record updated Nov 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN.0993727 Issued in CO
Practice address
3676 Parker Blvd
Pueblo, CO 81008-2212
Phone
(719) 553-2200
NPI assigned
Jun 14, 2018
Last updated
Nov 16, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2022

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 APN.0993727 CO Primary

Addresses

Primary practice location

3676 Parker Blvd
Pueblo, CO 81008-2212

Mailing address

3676 Parker Blvd Ste 260
Pueblo, CO 81008-2282
Phone (719) 553-2201

Other identifiers 1

IdentifierTypeStateIssuer
14288871OtherCOCAQH

Other names 1

  • Tarah McBeain Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180806001029 CO Practitioner - Nurse Practitioner 8527316660 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern Colorado Clinic PCGroup PAC ID 4284524067, 36 clinicians

Practice addresses (Care Compare)

3676 Parker Blvd
Suite 290
Pueblo, CO 81008-2214
Phone (719) 553-2200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APN.0993727COMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Colorado Clinic PC CurrentSince Aug 1, 2018 Accepting new patients

Locations

314 W 16th St
Pueblo, CO 81003
Phone (719) 546-3511

3676 Parker Blvd
Pueblo, CO 81008
Phone (719) 253-7000

3676 Parker Blvd
Ste 260
Pueblo, CO 81008
Phone (719) 553-2201

3676 Parker Blvd
Ste 290
Pueblo, CO 81008
Phone (719) 553-2200

Interoperability endpoints

  • Direct secure messaging: tarah.sellner.1@21306.direct.athenahealth.com

Organizations & group practices 1

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 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1528934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668556800000",
    "number": "1659865533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3676 PARKER BLVD STE 260",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810082282",
            "telephone_number": "719-553-2201",
            "fax_number": "833-916-2047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3676 PARKER BLVD",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810082212",
            "telephone_number": "719-553-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELLNER",
        "first_name": "TARAH",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-14",
        "last_updated": "2022-11-16",
        "certification_date": "2022-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.0993727",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "14288871",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TARAH",
            "last_name": "MCBEAIN",
            "credential": "FNP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.