NPIMap

Individual provider Active NPI

Tara H Rahmlow, MD

  • Internal Medicine Physician
  • Jonesboro, AR
National Provider Identifier
1831712546
Registry record updated Aug 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
E-17016 Issued in AR
Practice address
225 E Washington Ave
Jonesboro, AR 72401-3111
Phone
(870) 207-4100
NPI assigned
May 28, 2020
Last updated
Aug 4, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Internal Medicine Physician 207R00000X E-17016 AR Primary

Addresses

Primary practice location

225 E Washington Ave
Jonesboro, AR 72401-3111

Mailing address

PO Box 141
Scott, AR 72142-0141
Phone (561) 267-5832

Other names 1

  • Tara Ganelle Hendrickson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230920000346 AR Practitioner - Internal Medicine 6406210780 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2018
Medicare assignment
May accept Medicare assignment
Group practices
St Bernards Hospital Inc.Group PAC ID 0941105480, 187 clinicians
Five Rivers Medical Center IncGroup PAC ID 1456540194, 37 clinicians
St Bernard Community Hospital CorporationGroup PAC ID 7810897485, shared by 4 NPIs, 12 clinicians

Practice addresses (Care Compare)

225 E Washington Ave
St Bernards Medical Center
Jonesboro, AR 72401-3119
Phone (870) 972-4100

2801 Medical Ctr Dr
Pocahontas, AR 72455-9436
Phone 87089260006200

310 Falls Blvd S
Wynne, AR 72396-3013
Phone (870) 238-3300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Five Rivers Medical Center Inc. Current Accepting new patients
St Bernards Hospital Inc. CurrentSince Aug 21, 2023 Accepting new patients
Five Rivers Medical Center Inc. CurrentSince Sep 1, 2025 Accepting new patients
Five Rivers Medical Center CurrentSince Sep 1, 2025 Accepting new patients

Locations

1201 Fleming Ave
Jonesboro, AR 72401
Phone (870) 932-0440

225 E Washington Ave
Jonesboro, AR 72401
Phone (870) 207-1630

2801 Medical Center Dr
Pocahontas, AR 72455
Phone (870) 892-6000

310 Falls Blvd S
Wynne, AR 72396
Phone (870) 208-2151

Organizations & group practices 6

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.

Hospital & facility affiliations 5

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": "1590624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691107200000",
    "number": "1831712546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 141",
            "city": "SCOTT",
            "state": "AR",
            "postal_code": "721420141",
            "telephone_number": "561-267-5832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 E WASHINGTON AVE",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724013111",
            "telephone_number": "870-207-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAHMLOW",
        "first_name": "TARA",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-28",
        "last_updated": "2023-08-04",
        "certification_date": "2023-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "E-17016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TARA",
            "last_name": "HENDRICKSON",
            "middle_name": "GANELLE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jonesboro, AR

Sources for this page

Verify at the official NPI Registry.