Individual provider Active NPI

Tara Kaufman

  • Women's Health Nurse Practitioner
  • Merrillville, IN
National Provider Identifier
1922695790
Registry record updated Dec 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
APRN.CNP.0028059 Issued in OH
Practice address
8645 Connecticut St
Merrillville, IN 46410-6222
Phone
(219) 769-3500
NPI assigned
Dec 28, 2020
Last updated
Dec 28, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X APRN.CNP.0028059 OH Primary
Registered Nurse 163W00000X 28263822A IN
Registered Nurse 163W00000X RN.458474 OH

Addresses

Primary practice location

8645 Connecticut St
Merrillville, IN 46410-6222

Mailing address

1962 Suffolk Rd
Columbus, OH 43221-4247
Phone (317) 750-4432

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
28263822AINMDRegistered Nurse
RN.458474OHMDRegistered Nurse
APRN.CNP.0028059OHMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Planned Parenthood Great Northwest, Hawai'I, Alaska, Indiana, Kentucky Women's Health Past Accepting new patients

Organizations & group practices 1

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": "1609113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609113600000",
    "number": "1922695790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1962 SUFFOLK RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432214247",
            "telephone_number": "317-750-4432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8645 CONNECTICUT ST",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464106222",
            "telephone_number": "219-769-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAUFMAN",
        "first_name": "TARA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-28",
        "last_updated": "2020-12-28",
        "certification_date": "2020-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "OH",
            "license": "APRN.CNP.0028059",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28263822A",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN.458474",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merrillville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.