Tara Rene Blackwelder, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

115187 Issued in NE

Practice address

224 W D. L. Ingram Avenue, BLDG. 1408
Cannon AFB, NM 88103-5014

Phone

(575) 784-2778

NPI assigned

Sep 27, 2013

Last updated

Dec 11, 2025By the provider in NPPES

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

Enrolled in NE

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

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Alegent Creighton ClinicGroup PAC ID 1951210418, 951 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• CHI Health Immanuel Hospital, Omaha, NE, CCN 280081
• CHI Health Bergan Mercy Hospital, Omaha, NE, CCN 280060

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tblackwelder894860@achce.catholichealth.net

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.

• Alegent Creighton Clinic

  dba CHI Health Clinic

  • Family Medicine Physician
  • Omaha, NE
  • NPI 1548287907
  Medicare reassignment Care Compare group NPD
• Alegent Creighton Clinic

  dba CHI Health Clinic

  • Internal Medicine Physician
  • Omaha, NE
  • NPI 1154680700
  NPD (past)
• Alegent Creighton Clinic

  dba CHI Health Clinic

  • Family Medicine Physician
  • Council Bluffs, IA
  • NPI 1598811069
  NPD (past)

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

• Alegent Health Bergan Mercy Health System

  dba Lasting Hope Recovery Center

  • Psychiatric Hospital Unit
  • Omaha, NE
  • NPI 1396969499
  Care Compare affiliation
• Alegent Health Bergan Mercy Health System

  dba CHI Health Creighton University Medical Center-Bergan Mercy

  • General Acute Care Hospital
  • Omaha, NE
  • NPI 1508941097
  Care Compare affiliation
• Alegent Health Immanuel Medical Center

  dba CHI Health Immanuel

  • General Acute Care Hospital
  • Omaha, NE
  • NPI 1912085184
  Care Compare affiliation

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

{
    "created_epoch": "1380240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765411200000",
    "number": "1831526557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27TH SPECIAL OPERATIONS MEDICAL GROUP",
            "address_2": "224 W D. L. INGRAM AVENUE, BLDG. 1408",
            "city": "CANNON AFB",
            "state": "NM",
            "postal_code": "881035014",
            "telephone_number": "575-784-2778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 W D. L. INGRAM AVENUE, BLDG. 1408",
            "city": "CANNON AFB",
            "state": "NM",
            "postal_code": "881035014",
            "telephone_number": "575-784-2778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKWELDER",
        "first_name": "TARA",
        "middle_name": "RENE",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-27",
        "last_updated": "2025-12-11",
        "certification_date": "2025-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NE",
            "license": "115187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nancy Barquin Barron, LPC
• Matthew Richard Bass, PT, DPT
• Jillian Marie Beausoleil, IDMT
• Nicholas E Bem, OD
• Ashton Nicole Bierbrauer-Martin, APRN, FNP-C
• Ericka Jean Bond, LCSW
• Bryan W Bovitz, PHD
• Holly J Brooks, LPN
• Kayla Irwin Brooks
• Jade Brown

• Family Nurse Practitioner in Cannon AFB, NM
• Providers in Cannon AFB, NM by specialty
• Family Nurse Practitioner in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2025; 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.