Active NPI
Anthony David Tarr, FNP-C
- Family Nurse Practitioner
- Belleville, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 209016200
- Practice address
- 4600 Memorial Dr Ste 120
Belleville, IL 62226-5359 - Phone
- (618) 222-1020
- NPI assigned
- Nov 15, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Medicine Registered Nurse | 163WC0200X | 041405030 | IL | |
| Critical Care Medicine Registered Nurse | 163WC0200X | 2012004299 | MO | |
| Family Nurse Practitioner | 363LF0000X | 209016200 | IL | Primary |
Addresses
Primary practice location
4600 Memorial Dr Ste 120
Belleville, IL 62226-5359
Mailing address
4600 Memorial Dr Ste 120
Belleville, IL 62226-5359
Phone (618) 222-1020
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2 | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1201 S Grand Blvd
Saint Louis, MO 63104-1016
Phone (314) 617-2000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 041405030 | IL | MD | Critical Care Medicine Registered Nurse |
| 2012004299 | MO | MD | Critical Care Medicine Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| SSM Health Care Group | Current | Accepting new patients | |
| SSM Health Care Group | Current | Accepting new patients | |
| SSM Medical Group Inc. | Past | Accepting new patients |
Locations
1011 Bowles Ave
Ste 400
Fenton, MO 63026
Phone (314) 821-4884
10101 Woodfield Ln
Saint Louis, MO 63132
Phone (608) 280-4647
1031 Bellevue Ave
Ste 280A
Saint Louis, MO 63117
Phone (314) 617-2110
1201 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 257-8222
1225 S Grand Blvd
#3
Saint Louis, MO 63104
Phone (314) 977-5110
Interoperability endpoints
- atarr31402@direct-ehr-ssmhc.com
Organizations & group practices 3
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.
-
dba SLUCare Physician Group
- Internal Medicine Physician
- Saint Louis, MO
- NPI 1306589544
-
dba SLUCare Physician Group
- Dermatopathology Physician
- Saint Louis, MO
- NPI 1932844495
-
dba SSM Health Medical Group
- Durable Medical Equipment & Medical Supplies
- Fenton, MO
- NPI 1124579966
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba SSM Health Cardinal Glennon Children's Hospital
- General Acute Care Hospital
- Saint Louis, MO
- NPI 1336387836
-
dba SSM Health St. Clare Hospital - Fenton
- General Acute Care Hospital
- Fenton, MO
- NPI 1851496152
-
dba SSM Health St. Mary's Hospital - St. Louis
- General Acute Care Hospital
- Saint Louis, MO
- NPI 1962572396
-
- Rehabilitation Hospital
- Richmond Heights, MO
- NPI 1659511988
Inpatient rehabilitation facility
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1479168000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621209600000",
"number": "1821530304",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4600 MEMORIAL DR STE 120",
"city": "BELLEVILLE",
"state": "IL",
"postal_code": "622265359",
"telephone_number": "618-222-1020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4600 MEMORIAL DR STE 120",
"city": "BELLEVILLE",
"state": "IL",
"postal_code": "622265359",
"telephone_number": "618-222-1020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TARR",
"first_name": "ANTHONY",
"middle_name": "DAVID",
"name_prefix": "Mr.",
"credential": "FNP-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-11-15",
"last_updated": "2021-05-17",
"certification_date": "2021-05-17",
"status": "A"
},
"taxonomies": [
{
"code": "163WC0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, Critical Care Medicine",
"state": "IL",
"license": "041405030",
"primary": false
},
{
"code": "163WC0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, Critical Care Medicine",
"state": "MO",
"license": "2012004299",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IL",
"license": "209016200",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2",
"affiliation": "N",
"endpointDescription": "BJC",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "4600 Memorial Dr Ste 120",
"city": "Belleville",
"state": "IL",
"country_code": "US",
"postal_code": "622265359",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Belleville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2021; 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.