Taris Gonzalez, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

71001601A Issued in IN

Practice address

426 N Crystal Dr
Fortville, IN 46040-1688

Phone

(317) 743-0009

NPI assigned

Jun 4, 2007

Sex

Female

Sole proprietor

Yes

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.

• GSG Pride Healthcare LLC

  • Primary Care Clinic/Center
  • Fortville, IN
  • NPI 1437622701

  IN

  Medicare reassignment NPD Authorized official
• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)
• Maoac, LLC

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Fishers, IN
  • NPI 1730663923
  NPD (past)
• Signal Business Administration Inc

  • Internal Medicine Physician
  • Indianapolis, IN
  • NPI 1407405459
  NPD (past)
• Signal Health Group Inc

  • Home Health Agency
  • Muncie, IN
  • NPI 1609383215
  NPD (past)

Specialty

Nurse Practitioner

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare fee-for-service enrollment

Enrolled in IN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: taris.gonzalez.1@18915.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/18915/brand/1/csg/1/fhir/r4
• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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

Specialties & licenses 2

Addresses

Other identifiers 2

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

{
    "created_epoch": "1180915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784764800000",
    "number": "1821290743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "426 N CRYSTAL DR",
            "city": "FORTVILLE",
            "state": "IN",
            "postal_code": "460401688",
            "telephone_number": "317-743-0009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "426 N CRYSTAL DR",
            "city": "FORTVILLE",
            "state": "IN",
            "postal_code": "460401688",
            "telephone_number": "317-743-0009"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8856 South St",
            "address_purpose": "LOCATION",
            "city": "Fishers",
            "state": "IN",
            "postal_code": "460382911",
            "country_code": "US",
            "telephone_number": "317-516-1177",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "135 Jordan Rd",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462174003",
            "country_code": "US",
            "telephone_number": "800-260-6145",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "625 S Tillotson Ave",
            "address_purpose": "LOCATION",
            "city": "Muncie",
            "state": "IN",
            "postal_code": "473044449",
            "country_code": "US",
            "telephone_number": "800-260-6145",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "TARIS",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-04",
        "last_updated": "2026-07-23",
        "certification_date": "2026-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71001601A",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IN",
            "license": "71001601",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PTAN",
            "identifier": "P01170026",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200460280",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Fortville Family Denistry LLC
• Fortville Smile Station
• Ann M Gang, NP
• Garst RX LLC
• Eric Garst, RPH
• Lacey Nichole Groce, MA, BCBA
• GSG Pride Healthcare LLC
• Jaclyn A Guglielmo, BCBA
• Sajid Hameed, P.T.
• Hancock Regional Hospital

• All providers in Fortville, IN
• Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2026; 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.