Tara N Haraldson, PNP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

AP124420 Issued in TX

Practice address

136 El Chico TRL Ste 102
Willow Park, TX 76087-8864

Phone

(817) 441-5412

Fax

(817) 441-9354

NPI assigned

Sep 25, 2013

Last updated

May 13, 2021By 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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tharaldson14249@cookchildrens.direct-ci.com

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.

• Cook Children's Physician Network

  • Pediatrics Physician
  • Fort Worth, TX
  • NPI 1083472062
  NPD
• Cook Children's Physician Network

  • Pediatrics Physician
  • Fort Worth, TX
  • NPI 1750369203
  NPD

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

{
    "created_epoch": "1380067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620864000000",
    "number": "1851727671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 733784",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753733784",
            "telephone_number": "682-885-1855",
            "fax_number": "682-885-1396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 EL CHICO TRL STE 102",
            "city": "WILLOW PARK",
            "state": "TX",
            "postal_code": "760878864",
            "telephone_number": "817-441-5412",
            "fax_number": "817-441-9354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARALDSON",
        "first_name": "TARA",
        "middle_name": "N",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-25",
        "last_updated": "2021-05-13",
        "certification_date": "2021-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TX",
            "license": "AP124420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tharaldson14249@CookChildrens.direct-ci.com",
            "affiliation": "N",
            "address_1": "136 El Chico Trl Ste 102",
            "city": "Willow Park",
            "state": "TX",
            "country_code": "US",
            "postal_code": "760878864",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sarah Grimmer, PHD
• Kelcy Reagan Guebard, M.ED., BCBA
• Latricia Hackfeld, LPC
• Rachael Halcomb, LCSW
• Diana Hamilton, PSY.D.
• Kelseigh Hardin
• Kai Steven Hatch, DMD
• Ashley Hawkins
• Michelle Hazelton, LMSW
• Healthy Nutrition Service (Healthy Nutrition Services, LLC)

• Primary Care Nurse Practitioner in Willow Park, TX
• Providers in Willow Park, TX by specialty
• Primary Care Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.