Active NPI
Leanne D. Tarr, PA-C
- Physician Assistant
- Lacey, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA60683788
- Practice address
- 4800 College St SE
PMG SW Wa Lacey Immediate Care
Lacey, WA 98503 - Phone
- (360) 486-2900
- Fax
- (360) 486-2901
- NPI assigned
- Nov 21, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA60683788 | WA | Primary |
Addresses
Primary practice location
4800 College St SE
PMG SW Wa Lacey Immediate Care
Lacey, WA 98503
Mailing address
PO Box 3360
Portland, OR 97208-3360
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | ltarr683309@wm.providencedirect.org | ||
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20641 | CA | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Permanente Medical Group, Inc | Current | Accepting new patients | |
| Permanente Medical Group Inc | Current | Accepting new patients | |
| Patient First Richmond Medical Group PLLC | Past | Accepting new patients |
Locations
1800 Harrison St
Fl 7
Oakland, CA 94612
1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015
901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500
501 J St
Sacramento, CA 95814
Phone (916) 497-3000
6600 Bruceville Rd
Sacramento, CA 95823
2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000
710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400
5615 Scotts Valley Dr
Scotts Valley, CA 95066
Phone (831) 430-2700
7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000
975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000
Interoperability endpoints
- ltarr@osnc2021.srs-direct.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 and National Provider Directory roles.
-
- Internal Medicine Physician
- Santa Clara, CA
- NPI 1073606299
-
- Internal Medicine Physician
- Redwood City, CA
- NPI 1639252604
-
- Clinical Medical Laboratory
- San Jose, CA
- NPI 1497971584
-
- Family Medicine Physician
- Glen Allen, VA
- NPI 1689603748
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1258761600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643932800000",
"number": "1740518208",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3360",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972083360"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4800 COLLEGE ST SE",
"address_2": "PMG SW WA LACEY IMMEDIATE CARE",
"city": "LACEY",
"state": "WA",
"postal_code": "98503",
"telephone_number": "360-486-2900",
"fax_number": "360-486-2901"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TARR",
"first_name": "LEANNE",
"middle_name": "D.",
"name_prefix": "Ms.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-11-21",
"last_updated": "2022-02-04",
"certification_date": "2022-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "WA",
"license": "PA60683788",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "ltarr683309@wm.providencedirect.org",
"affiliation": "N",
"address_1": "4800 COLLEGE ST SE",
"address_2": "PMG SW WA LACEY IMMEDIATE CARE",
"city": "Lacey",
"state": "WA",
"country_code": "US",
"postal_code": "98503",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
"affiliation": "N",
"endpointDescription": "Carequality",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "6600 Bruceville Rd",
"city": "Sacramento",
"state": "CA",
"country_code": "US",
"postal_code": "958234671",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Lacey, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.