Individual provider Active NPI

Tara Danette Brown, APN

  • Pediatric Nurse Practitioner
  • Little Rock, AR
National Provider Identifier
1902157571
Registry record updated Mar 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
A003760 Issued in AR
Practice address
1 Childrens Way # 512-13
Little Rock, AR 72202-3500
Phone
(501) 364-1100
Fax
(501) 364-4082
NPI assigned
Sep 24, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 16972 TN
Pediatric Nurse Practitioner 363LP0200X 1084095 TX
Pediatric Nurse Practitioner 363LP0200X A003760 AR Primary

Addresses

Primary practice location

1 Childrens Way # 512-13
Little Rock, AR 72202-3500

Mailing address

1 Childrens Way # 653
Little Rock, AR 72202-3500
Phone (501) 364-1100

Other practice location 1

262 Danny Thomas Pl
Memphis, TN 38105-3678
Phone (901) 595-3300

Other names 1

  • Tara H Hubbart Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20240409003935 AR Practitioner - Nurse Practitioner 2567604085 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
16972TNMDSpecialist
1084095TXMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Arkansas for Medical Sciences CurrentSince Mar 28, 2024 Accepting new patients
Arkansas Children'S Hospital CurrentSince Mar 28, 2024 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Mar 28, 2024 Accepting new patients
Arkansas Childrens Hospital CurrentSince Mar 28, 2024 Accepting new patients
Arkansas Childrens Hospital Past Accepting new patients

Locations

4301 W Markham St
#783
Little Rock, AR 72205
Phone (501) 603-1278

1 Childrens Way
Little Rock, AR 72202
Phone (501) 364-1874

1 Childrens Way
#653
Little Rock, AR 72202
Phone (501) 614-2006

1 Childrens Way
#51213
Little Rock, AR 72202
Phone (501) 364-3082

1 Childrens Way
Ste 653
Little Rock, AR 72202

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1348444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711584000000",
    "number": "1902157571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS WAY # 653",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722023500",
            "telephone_number": "501-364-1100",
            "fax_number": "501-364-4082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS WAY # 512-13",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722023500",
            "telephone_number": "501-364-1100",
            "fax_number": "501-364-4082"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "262 Danny Thomas Pl",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381053678",
            "country_code": "US",
            "telephone_number": "901-595-3300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "TARA",
        "middle_name": "DANETTE",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-24",
        "last_updated": "2024-03-28",
        "certification_date": "2024-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TN",
            "license": "16972",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "1084095",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "AR",
            "license": "A003760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TARA",
            "last_name": "HUBBART",
            "middle_name": "H",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.