Tara CL Dwelley, CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R049268 Issued in ME

Practice address

136 Mill St
Princeton, ME 04668-3344

Phone

(207) 796-5503

Fax

(207) 796-5528

NPI assigned

Apr 19, 2006

Last updated

Jul 22, 2022By 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 identifiers 1

Medicare fee-for-service enrollment

Enrolled in ME

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 1

Specialty

Nurse Practitioner

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Croix Regional Family Health CenterGroup PAC ID 3577524024, 21 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Calais Community Hospital Hospital, Calais, ME, CCN 201305
• Northern Light Eastern Maine Medical Center Hospital, Bangor, ME, CCN 200033

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/BCGABA

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.

• St Croix Regional Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Princeton, ME
  • NPI 1831174614
  Medicare reassignment Care Compare group NPD
• Family Medicine Associates of Waterville PA

  • Family Medicine Physician
  • Waterville, ME
  • NPI 1508841941
  NPD (past)
• St Croix Regional Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Calais, ME
  • NPI 1083379655
  NPD (past)
• St Croix Regional Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Calais, ME
  • NPI 1467573469
  NPD (past)

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

• Calais Community Hospital

  • Critical Access Hospital
  • Calais, ME
  • NPI 1922001049
  Care Compare affiliation
• Eastern Maine Medical Center

  • General Acute Care Hospital
  • Bangor, ME
  • NPI 1790789147
  Care Compare affiliation

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658448000000",
    "number": "1780649137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 MILL ST",
            "city": "PRINCETON",
            "state": "ME",
            "postal_code": "046683344",
            "telephone_number": "207-796-5503",
            "fax_number": "207-796-5528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 MILL ST",
            "city": "PRINCETON",
            "state": "ME",
            "postal_code": "046683344",
            "telephone_number": "207-796-5503",
            "fax_number": "207-796-5528"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5 Lowell St Ste 4",
            "address_purpose": "LOCATION",
            "city": "Calais",
            "state": "ME",
            "postal_code": "046191712",
            "country_code": "US",
            "telephone_number": "207-796-5503",
            "fax_number": "207-796-5528",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "35 Blue Devil Hill",
            "address_purpose": "LOCATION",
            "city": "Calais",
            "state": "ME",
            "postal_code": "04619",
            "country_code": "US",
            "telephone_number": "207-796-5503",
            "fax_number": "207-796-5528",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DWELLEY",
        "first_name": "TARA",
        "middle_name": "CL",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-19",
        "last_updated": "2022-07-22",
        "certification_date": "2022-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ME",
            "license": "R049268",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "431937699",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Beth Ann Chabre, NP
• Lawrence Crystal, DPM
• Deborah Lynn Daggett, L.A.D.C
• Michael J Driscoll, LCPC, LADC, CCS
• Jonathan Adam Dudek, PH.D.
• Gregory Michael Farrell, O.D.
• Michael Farrell, D.C.
• Carol Francis, RN
• Merlin J Francis, NP
• Truman L Gillette, PHARMACIST

• Family Nurse Practitioner in Princeton, ME
• Providers in Princeton, ME by specialty
• Family Nurse Practitioner in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.