Individual provider Active NPI

Petronella Taku Bell, M.D

  • Child & Adolescent Psychiatry Physician
  • Tallahassee, FL
National Provider Identifier
1861768392
Registry record updated Sep 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
ME157646 Issued in FL
Practice address
1334 Timberlane Rd Ste 18
Tallahassee, FL 32312-1766
Phone
(850) 567-9707
Fax
(800) 692-0493
NPI assigned
Mar 29, 2012
Last updated
Sep 5, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X ME157646 FL
Child & Adolescent Psychiatry Physician 2084P0804X ME157646 FL Primary

Addresses

Primary practice location

1334 Timberlane Rd Ste 18
Tallahassee, FL 32312-1766

Mailing address

3425 Bannerman Rd Ste 105-217
Tallahassee, FL 32312-7062
Phone (850) 567-9707

Other names 1

  • Dr. Petronella Taku Mbu Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, WI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170918001944 VA Practitioner - Psychiatry 6800106196 Reassigns benefits to 1 organization
I20250905004246 WI Practitioner - Psychiatry 6800106196 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2012
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

400 W River Woods Pkwy
Glendale, WI 53212-1060

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME157646FLMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Specialty Group PLLC CurrentSince Nov 1, 2022 Accepting new patients
Tranquil Haven Child & Adolescent Psychiatry CurrentSince Feb 23, 2025 Accepting new patients
Ascension Medical Group-Fox Valley Wisconsin, Inc General Practice CurrentSince Jul 4, 2025 Accepting new patients
Ascension Medical Group-Fox Valley Wisconsin, Inc CurrentSince Jul 4, 2025 Accepting new patients

Locations

3425 Bannerman Rd
Ste 105217
Tallahassee, FL 32312
Phone (850) 567-9707

601 Childrens Ln
Norfolk, VA 23507
Phone (757) 668-7272

850 Southampton Ave
Norfolk, VA 23510
Phone (757) 668-4673

1501 S Madison St
Appleton, WI 54915
Phone (920) 730-4435

1506 S Oneida St
Fl 5
Appleton, WI 54915
Phone (920) 730-4950

2700 W 9th Ave
Oshkosh, WI 54904
Phone (920) 223-0220

Organizations & group practices 4

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": "1332979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757030400000",
    "number": "1861768392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3425 BANNERMAN RD STE 105-217",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323127062",
            "telephone_number": "850-567-9707",
            "fax_number": "800-962-0493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1334 TIMBERLANE RD STE 18",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323121766",
            "telephone_number": "850-567-9707",
            "fax_number": "800-692-0493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELL",
        "first_name": "PETRONELLA",
        "middle_name": "TAKU",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-29",
        "last_updated": "2025-09-05",
        "certification_date": "2025-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME157646",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "FL",
            "license": "ME157646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PETRONELLA",
            "last_name": "MBU",
            "middle_name": "TAKU",
            "prefix": "DR.",
            "credential": "M.D",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tallahassee, FL

Sources for this page

Verify at the official NPI Registry.