Tanja Mead, MSN, FNP
Individual provider Active NPI Family Nurse Practitioner · Trumann, AR
NPI 1902903636 · NPPES record last updated May 26, 2021
Key facts
- NPI
- 1902903636
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- A02930ANP (AR)
- Practice address
- 417 W Main St
Trumann, AR 72472-3116 - Phone
- (870) 483-1025
- Fax
- (870) 483-1057
- NPI assigned
- Sep 17, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 13
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- East Arkansas Family Health Center, Inc
Practice addresses (Care Compare)
216 Arkansas St
Earle, AR 72331-2217
Phone (870) 792-7676
417 W Main St
Trumann, AR 72472-3116
Phone (870) 483-1025
513 Porter St
Helena, AR 72342-3217
Phone (870) 817-0122
605 N 2ND St
Healthy Partners
Blytheville, AR 72315-2034
Phone (870) 532-6001
900 N 7TH St
West Memphis, AR 72301-2001
Hospital & facility affiliations
- St Bernards Medical Center
- Baptist Memorial Hospital Jonesboro, Inc.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110805000467 | AR | Practitioner - Nurse Practitioner | 9739115221 | Reassigns benefits to 5 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science - Nursing, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A02930ANP | AR | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| East Arkansas Family Health Center, Inc | Current | Accepting new patients | |
| East Arkansas Family Health Center, Inc | Current |
Accepting new patients | |
| East Arkansas Family Health Center Inc. | Current |
Accepting new patients | |
| East Arkansas Family Health Center Inc. | Current |
Accepting new patients | |
| Memphis Lung Physicians, P.C. | Past | Accepting new patients |
Locations
605 N 2nd St
Blytheville, AR 72315
Phone (870) 532-6001
216 Arkansas St
Earle, AR 72331
Phone (870) 792-7676
513 Porter St
Helena, AR 72342
Phone (870) 817-0122
102 W Broad St
Lepanto, AR 72354
Phone (870) 475-2977
417 W Main St
#B
Trumann, AR 72472
Phone (870) 483-7039
900 N 7th St
West Memphis, AR 72301
Phone (870) 735-3842
Interoperability endpoints
- tmead13440@direct.bmhcc.org
- tanja.mead@eastarkan.eclinicaldirectplus.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | A02930ANP | AR | Yes |
Addresses
Primary practice location
417 W Main St
Trumann, AR 72472-3116
Mailing address
417 W Main St
Trumann, AR 72472-3116
Phone (870) 483-1025
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 185659758 | Medicaid | AR |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | tanja.mead@eastarkan.eclinicaldirectplus.com |
NPI Registry JSON
{
"created_epoch": "1158451200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621987200000",
"number": "1902903636",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "417 W MAIN ST",
"city": "TRUMANN",
"state": "AR",
"postal_code": "724723116",
"telephone_number": "870-483-1025",
"fax_number": "870-483-1057"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "417 W MAIN ST",
"city": "TRUMANN",
"state": "AR",
"postal_code": "724723116",
"telephone_number": "870-483-1025",
"fax_number": "870-483-1057"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEAD",
"first_name": "TANJA",
"name_prefix": "Mrs.",
"credential": "MSN, FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-17",
"last_updated": "2021-05-26",
"certification_date": "2021-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "AR",
"license": "A02930ANP",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "185659758",
"state": "AR"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "tanja.mead@eastarkan.eclinicaldirectplus.com",
"affiliation": "N",
"address_1": "417 W Main St",
"city": "Trumann",
"state": "AR",
"country_code": "US",
"postal_code": "724723116",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Trumann, AR
- Kristan McDonald
- Lajoya McDonald
- Samantha Ann McFadden
- Brandi Lynn McGuire
- Hollie Kay McLaughlin
- Cynthia Meador
- Med Care, Inc
- Jessica Diane Meilke
- Kayla Miller
- Jennifer Milligan
All providers in Trumann, AR · Family Nurse Practitioner in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 26, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.