NPIMap

Individual provider Active NPI

Tara Jewell, NP-C

  • Adult Health Nurse Practitioner
  • Fort Collins, CO
National Provider Identifier
1669893699
Registry record updated Sep 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
306752 Issued in NY
Practice address
3702 S Timberline Rd
BLDG a
Fort Collins, CO 80525-3624
Phone
(970) 212-0879
Fax
(970) 484-8667
NPI assigned
Dec 17, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 340927 NY
Gerontology Nurse Practitioner 363LG0600X 0992029 CO
Adult Health Nurse Practitioner 363LA2200X 306752 NY Primary

Addresses

Primary practice location

3702 S Timberline Rd
BLDG a
Fort Collins, CO 80525-3624

Mailing address

3702 S Timberline Rd
BLDG a
Fort Collins, CO 80525-3624
Phone (970) 212-0879

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
I20151112002221 CO Practitioner - Nurse Practitioner 5294952263 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centers for GastroenterologyGroup PAC ID 9537059555, 38 clinicians

Practice addresses (Care Compare)

3702 S Timberline Rd
Suite a
Fort Collins, CO 80525-3625
Phone (970) 207-9773

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
60.52 of 100Reported as group
Quality
0
Promoting interoperability
100
Improvement activities
40
Cost
68.38

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
306752NYMDAdult Health Nurse Practitioner
0992029COMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Centers for Gastroenterology CurrentSince Oct 28, 2015 Accepting new patients

Locations

3702 S Timberline Rd
Ste A
Fort Collins, CO 80525
Phone (970) 207-9773

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 and National Provider Directory roles.

Hospital & facility affiliations 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1387238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632268800000",
    "number": "1669893699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3702 S TIMBERLINE RD",
            "address_2": "BLDG A",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805253624",
            "telephone_number": "970-212-0879",
            "fax_number": "970-484-8667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3702 S TIMBERLINE RD",
            "address_2": "BLDG A",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805253624",
            "telephone_number": "970-212-0879",
            "fax_number": "970-484-8667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEWELL",
        "first_name": "TARA",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-17",
        "last_updated": "2021-09-22",
        "certification_date": "2021-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NY",
            "license": "340927",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CO",
            "license": "0992029",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "306752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.