Individual provider Active NPI

Tara Elizabeth Bronson, MSN, FNP-C

  • Nurse Practitioner
  • Middletown, RI
National Provider Identifier
1720485642
Registry record updated Sep 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN00867 Issued in RI
Practice address
672 Aquidneck Ave
Middletown, RI 02842-5795
Phone
(401) 847-0159
Fax
(401) 846-0283
NPI assigned
Nov 20, 2014
Last updated
Sep 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN00867 RI Primary
Nurse Practitioner 363L00000X RN257511 MA

Addresses

Primary practice location

672 Aquidneck Ave
Middletown, RI 02842-5795

Mailing address

200 Mill Rd Ste 180
Fairhaven, MA 02719-5255
Phone (508) 973-2000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tbronson13384@direct.southcoast.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI, MA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150319000193 RI Practitioner - Nurse Practitioner 8325365919 Reassigns benefits to 1 organization
I20201023000110 MA Practitioner - Nurse Practitioner 8325365919 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
Telehealth
Offers telehealth services
Group practices
Southcoast Physicians Group IncGroup PAC ID 0749171957, 875 clinicians

Practice addresses (Care Compare)

11 Friendship St
Newport, RI 02840-2209
Phone (401) 846-6400

500 Faunce Corner Rd
North Dartmouth, MA 02747-1278
Phone (508) 973-2216

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN00867RIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southcoast Physicians Group, Inc. CurrentSince Feb 2, 2015 Accepting new patients
Southcoast Physicians Group, Inc. CurrentSince Feb 2, 2015 Accepting new patients

Locations

200 Mill Rd
Ste 180
Fairhaven, MA 02719
Phone (508) 973-2000

534 Prospect St
Fall River, MA 02720
Phone (508) 679-7766

500 Faunce Corner Rd
North Dartmouth, MA 02747
Phone (508) 973-2216

672 Aquidneck Ave
Middletown, RI 02842
Phone (401) 847-0519

714 Aquidneck Ave
Middletown, RI 02842
Phone (401) 414-5212

11 Friendship St
Newport, RI 02840
Phone (401) 845-1110

Organizations & group practices 2

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": "1416441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725148800000",
    "number": "1720485642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MILL RD STE 180",
            "city": "FAIRHAVEN",
            "state": "MA",
            "postal_code": "027195255",
            "telephone_number": "508-973-2000",
            "fax_number": "508-973-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "672 AQUIDNECK AVE",
            "city": "MIDDLETOWN",
            "state": "RI",
            "postal_code": "028425795",
            "telephone_number": "401-847-0159",
            "fax_number": "401-846-0283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRONSON",
        "first_name": "TARA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "MSN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-20",
        "last_updated": "2024-09-01",
        "certification_date": "2024-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "RI",
            "license": "APRN00867",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN257511",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tbronson13384@direct.southcoast.org",
            "affiliation": "N",
            "endpointDescription": "Southcoast Health Epic Direct Address",
            "address_1": "714 Aquidneck Ave",
            "city": "Middletown",
            "state": "RI",
            "country_code": "US",
            "postal_code": "028425796",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Middletown, RI

Sources for this page

Verify at the official NPI Registry.