Tara Ann White, OT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

106544 Issued in MN

Practice address

3835 Supreme CT NW Ste 2
Bemidji, MN 56601-4485

Phone

(218) 444-8280

NPI assigned

Sep 9, 2021

Last updated

Sep 9, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Tara Ann Bergeron Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1631145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631145600000",
    "number": "1750050076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3835 SUPREME CT NW STE 2",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566014485",
            "telephone_number": "218-444-8280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3835 SUPREME CT NW STE 2",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566014485",
            "telephone_number": "218-444-8280"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "50 Margaret Ave NE",
            "address_purpose": "LOCATION",
            "city": "Blackduck",
            "state": "MN",
            "postal_code": "566304509",
            "country_code": "US",
            "telephone_number": "218-835-3425",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "118 Central Street West",
            "address_purpose": "LOCATION",
            "city": "Bagley",
            "state": "MN",
            "postal_code": "566215662",
            "country_code": "US",
            "telephone_number": "218-694-3030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITE",
        "first_name": "TARA",
        "middle_name": "ANN",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-09",
        "last_updated": "2021-09-09",
        "certification_date": "2021-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "106544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TARA",
            "last_name": "BERGERON",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Maureen Whelan, O.D.
• White Earth Band of Ojibwe (Oshki Manidoo MAT Program)
• White Earth Oshki Manidoo New Spirit Center (Oshki Manidoo Center)
• Diane Elaine White
• Mercideze Alexis White, LICSW
• Zachary J White
• Lindsey Marie Whiting, APRN-FNP
• Shawn Whiting, MA
• Chantel Justina Wickham, PT
• Charles-Camarin Widner, MSW, LGSW

• Occupational Therapist in Bemidji, MN
• Providers in Bemidji, MN by specialty
• Occupational Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.