Individual provider Active NPI

Tara Roychell Blair, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Thomson, GA
National Provider Identifier
1831057405
Registry record updated Oct 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN-NP-235127 Issued in GA
Practice address
523 Shadowmoor Cir
Thomson, GA 30824-8109
Phone
(706) 399-4695
NPI assigned
Jan 13, 2026
Last updated
Oct 22, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X APRN-NP-235127 GA Primary

Addresses

Primary practice location

523 Shadowmoor Cir
Thomson, GA 30824-8109

Mailing address

523 Shadowmoor Cir
Thomson, GA 30824-8109

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20260330002704 GA Practitioner - Nurse Practitioner 2961987748 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christopher Dennis MD PLLCGroup PAC ID 7416254990, 72 clinicians

Practice addresses (Care Compare)

11340 Lakefield Dr
Suite 200
Johns Creek, GA 30097-2456
Phone (888) 515-3834

3685 Wheeler Rd
Suite 100
Augusta, GA 30909-6640
Phone (706) 790-4440

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN-NP-235127GAMDPsychiatric/Mental Health Registered Nurse

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1768262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792627200000",
    "number": "1831057405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "523 SHADOWMOOR CIR",
            "city": "THOMSON",
            "state": "GA",
            "postal_code": "308248109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "523 SHADOWMOOR CIR",
            "city": "THOMSON",
            "state": "GA",
            "postal_code": "308248109",
            "telephone_number": "706-399-4695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAIR",
        "first_name": "TARA",
        "middle_name": "ROYCHELL",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-01-13",
        "last_updated": "2026-10-22",
        "certification_date": "2026-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "APRN-NP-235127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thomson, GA

Sources for this page

Verify at the official NPI Registry.