Individual provider Active NPI

Anthony David Tarr, FNP-C

  • Family Nurse Practitioner
  • Belleville, IL
National Provider Identifier
1821530304
Registry record updated May 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209016200 Issued in IL
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

Updated by the provider on May 17, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

TypeEndpointUseAffiliation
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230810002041 MO Practitioner - Nurse Practitioner 9133494479 Reassigns benefits to 1 organization

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
SSM Health Care GroupGroup PAC ID 0143608372, 929 clinicians

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

LicenseStateTypeSpecialty
041405030ILMDCritical Care Medicine Registered Nurse
2012004299MOMDCritical Care Medicine Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Health Care Group CurrentSince Aug 1, 2023 Accepting new patients
SSM Health Care Group CurrentSince Aug 1, 2023 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

  • Direct secure messaging: 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.

Hospital & facility affiliations 4

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

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

Verify at the official NPI Registry.