Tara McGinnis, NP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

AG06210179 Issued in KY

Practice address

2501 Saint Mary Dr
Camp Lejeune, NC 28547-1318

Phone

(619) 565-9380

NPI assigned

Oct 13, 2022

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1665619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665619200000",
    "number": "1811613524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 SAINT MARY DR",
            "city": "CAMP LEJEUNE",
            "state": "NC",
            "postal_code": "285471318",
            "telephone_number": "619-565-9380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 SAINT MARY DR",
            "city": "CAMP LEJEUNE",
            "state": "NC",
            "postal_code": "285471318",
            "telephone_number": "619-565-9380"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1672 Bantas Fork Rd",
            "address_purpose": "LOCATION",
            "city": "Pleasureville",
            "state": "KY",
            "postal_code": "400578748",
            "country_code": "US",
            "telephone_number": "619-565-9380",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCGINNIS",
        "first_name": "TARA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-13",
        "last_updated": "2022-10-13",
        "certification_date": "2022-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "KY",
            "license": "AG06210179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walter Joseph McDevitt Jr.
• David McDonald, APN
• Gavin Carter McEwan, M.D.
• Vanessa Fulton McFate, CRNP
• Michael G McGilton, LCSW
• William Anthony McGrath, SOIDC
• Peter Wren McGuyer, SOIDC
• Jordan McIntire
• Christopher McIntyre, IDC
• Corey McKenzie

• Gerontology Nurse Practitioner in Camp Lejeune, NC
• Providers in Camp Lejeune, NC by specialty
• Gerontology Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2022; 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.