Individual provider Active NPI

Jason Matthew Tallman, RN, APN-BC, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Roanoke, VA
National Provider Identifier
1942330014
Registry record updated Sep 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
F404803-01 Issued in NY
Practice address
2017 Jefferson St SW
Roanoke, VA 24014-2419
Phone
(540) 981-8025
NPI assigned
Mar 6, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2026

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

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APN14483 TN
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 0024186428 VA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP61417420 WA
Psychiatric/Mental Health Registered Nurse 163WP0808X RN0000135328 TN
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 10006695 OR
Psychiatric/Mental Health Nurse Practitioner 363LP0808X F404803-01 NY Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 5023466 NC
Psychiatric/Mental Health Registered Nurse 163WP0808X 873397-01 NY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 13728 MN
Psychiatric/Mental Health Nurse Practitioner 363LP0808X C-APN.0100144-C-NP CO

Addresses

Primary practice location

2017 Jefferson St SW
Roanoke, VA 24014-2419

Mailing address

213 S Jefferson St Ste 1006
Roanoke, VA 24011-1713

Other practice location 1

109 Kensington Pl
Columbia, TN 38401-8885
Phone (931) 446-1537

Other practice location 2

11600 W 2nd Pl
Lakewood, CO 80228-1527
Phone (720) 321-0000

Other practice location 3

4050 Coon Rapids Blvd NW
Coon Rapids, MN 55433-2522
Phone (612) 262-1220

Other practice location 4

6107 Pinewood Rd
Nunnelly, TN 37137-2523
Phone (888) 852-6672

Other practice location 5

1015 NW 22nd Ave
Portland, OR 97210-3025
Phone (503) 413-8949

Other practice location 6

700 Walter Reed Dr
Greensboro, NC 27403-1128
Phone (336) 832-9600

Other practice location 7

1 Atwell Rd
Cooperstown, NY 13326
Phone (607) 547-3525

Other practice location 8

1785 Route 9
Halfmoon, NY 12065-2449
Phone (518) 238-6028

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jtallman761620@excellian.direct.allina.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, NY, MI, CO, VA, OR, WA, NC, MN, WI10 enrollments
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 10

Enrollment IDStateProvider typePAC IDDetails
I20100113000511 TN Practitioner - Nurse Practitioner 6709927700 Reassigns benefits to 3 organizations
I20230608003329 NY Practitioner - Nurse Practitioner 6709927700 Reassigns benefits to 4 organizations
I20251007001264 MI Practitioner - Nurse Practitioner 6709927700 Reassigns benefits to 2 organizations
I20251017004130 CO Practitioner - Nurse Practitioner 6709927700 Reassigns benefits to 1 organization
I20251205000861 VA Practitioner - Nurse Practitioner 6709927700 Reassigns benefits to 1 organization
I20251219002947 OR Practitioner - Nurse Practitioner 6709927700 Reassigns benefits to 1 organization
I20251231002641 WA Practitioner - Nurse Practitioner 6709927700 Reassigns benefits to 1 organization
I20260327004101 NC Practitioner - Nurse Practitioner 6709927700 Reassigns benefits to 3 organizations
I20260622000880 MN Practitioner - Nurse Practitioner 6709927700 Reassigns benefits to 1 organization
I20260622001459 WI Practitioner - Nurse Practitioner 6709927700 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mary Imogene Bassett HospitalGroup PAC ID 3779488325, 780 clinicians
Legacy Clinics LLCGroup PAC ID 0244144004, 714 clinicians
Catholic Health Initiatives ColoradoGroup PAC ID 8022927342, 1,230 clinicians
Professional Medical Concierge Services PLLCGroup PAC ID 0840614020, 75 clinicians
Carilion Medical CenterGroup PAC ID 9830096585, 956 clinicians
McLaren Medical GroupGroup PAC ID 3971416082, 240 clinicians

Practice addresses (Care Compare)

1 Atwell Rd
Cooperstown, NY 13326-1301
Phone (607) 547-3480

1015 NW 22ND Ave
Portland, OR 97210-3025
Phone (503) 413-7711

11600 W 2ND PL
Sah Behavioral Health
Lakewood, CO 80228-1527
Phone (720) 321-0000

1785 Route 9
Halfmoon, NY 12065-2449
Phone (518) 238-6028

1906 Belleview Ave SE
Roanoke, VA 24014-1838
Phone (540) 981-7000

2017 Jefferson St SW
Roanoke, VA 24014-2419
Phone (540) 981-7925

2017 S Jefferson St
Roanoke, VA 24014-2419
Phone (540) 981-7128

2900 Collins Rd
Lansing, MI 48910-8394
Phone (517) 975-7500

45 Reade PL
Poughkeepsie, NY 12601-3947
Phone (845) 454-8500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
873397-01NYMDPsychiatric/Mental Health Registered Nurse
RN0000135328TNMDPsychiatric/Mental Health Registered Nurse
C-APN.0100144-C-NPCOMDPsychiatric/Mental Health Nurse Practitioner
5023466NCMDPsychiatric/Mental Health Nurse Practitioner
F404803-01NYMDPsychiatric/Mental Health Nurse Practitioner
10006695ORMDPsychiatric/Mental Health Nurse Practitioner
APN14483TNMDPsychiatric/Mental Health Nurse Practitioner
0024186428VAMDPsychiatric/Mental Health Nurse Practitioner
AP61417420WAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Salmon Creek Hospital CurrentSince Dec 9, 2025 Accepting new patients
Mary Imogene Bassett Hospital CurrentSince Nov 18, 2025 Accepting new patients
Carilion Medical Center CurrentSince Dec 1, 2025 Accepting new patients
Carilion Medical Center CurrentSince Dec 1, 2025 Accepting new patients
Catholic Health Initiatives Colorado CurrentSince Oct 7, 2025 Accepting new patients
Edward W Sparrow Hospital Association CurrentSince Oct 1, 2025 Accepting new patients
Peacehealth CurrentSince Dec 29, 2025 Accepting new patients
Legacy Salmon Creek Hospital CurrentSince Dec 9, 2025 Accepting new patients
Catholic Health Initiatives Colorado CurrentSince Oct 7, 2025 Accepting new patients
Legacy Clinics LLC CurrentSince Dec 9, 2025 Accepting new patients
Edward W. Sparrow Hospital Association CurrentSince Oct 1, 2025 Accepting new patients
Edward W. Sparrow Hospital Association Current Accepting new patients
McLaren Medical Group CurrentSince Oct 1, 2025 Accepting new patients
Mary Imogene Bassett Hospital CurrentSince Nov 18, 2025 Accepting new patients
McLaren Medical Group CurrentSince Oct 1, 2025 Accepting new patients
Legacy Clinics LLC CurrentSince Dec 9, 2025 Accepting new patients
Health Quest Medical Practice, PC CurrentSince May 3, 2023 Accepting new patients
Peacehealth CurrentSince Dec 30, 2025 Accepting new patients
Professional Medical Concierge Services, PLLC CurrentSince Oct 1, 2023 Accepting new patients
Nuvance Health Medical Practice PC CurrentSince May 3, 2023 Accepting new patients
Peacehealth CurrentSince Dec 30, 2025 Accepting new patients
Catholic Health Initiatives Colorado Current Accepting new patients
McLaren Medical Group Current Accepting new patients
Awakening Mindful Possibilities Psychiatric/Mental Health PastSince Nov 18, 2009 Accepting new patients

Locations (25 of 29)

11600 W 2nd Pl
Lakewood, CO 80228
Phone (720) 321-1010

41 State Highway 67
Woodland Park, CO 80863
Phone (719) 686-0551

8175 Reliable Pkwy
Chicago, IL 60686

1100 S Van Dyke Rd
Bad Axe, MI 48413
Phone (989) 269-9521

1900 Columbus Ave
Bay City, MI 48708
Phone (989) 894-3000

401 N Hooper St
Caro, MI 48723
Phone (517) 673-3141

401 S Ballenger Hwy
Flint, MI 48532
Phone (810) 342-1000

5979 Lakeshore Rd
Fort Gratiot, MI 48059
Phone (810) 385-6370

1210 W Saginaw St
Fl 2
Lansing, MI 48915
Phone (517) 364-7575

2900 Collins Rd
Lansing, MI 48910
Phone (517) 975-7500

1215 E Michigan Ave
Lansing, MI 48912
Phone (517) 336-8080

1375 N Main St
Lapeer, MI 48446
Phone (810) 667-5500

1254 N Main St
Lapeer, MI 48446
Phone (810) 664-4531

1000 Harrington St
Mount Clemens, MI 48043
Phone (586) 493-3727

416 Connable Ave
Petoskey, MI 49770
Phone (231) 487-4000

50 N Perry St
Pontiac, MI 48342
Phone (248) 338-5300

178 Grandview Dr
Cobleskill, NY 12043
Phone (518) 254-3456

1 Atwell Rd
Cooperstown, NY 13326
Phone (607) 547-3480

1785 Route 9
Halfmoon, NY 12065
Phone (518) 238-6028

45 Reade Pl
Fl 2
Poughkeepsie, NY 12601
Phone (845) 483-6001

45 Reade Pl
Poughkeepsie, NY 12601
Phone (845) 331-3131

6511 Spring Brook Ave
Rhinebeck, NY 12572
Phone (845) 871-3368

130 North St
Walton, NY 13856
Phone (607) 865-6541

1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134

2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200

Interoperability endpoints

  • Direct secure messaging: jtallman3031576@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 30

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.

View all 30

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788825600000",
    "number": "1942330014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 S JEFFERSON ST STE 1006",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240111713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2017 JEFFERSON ST SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240142419",
            "telephone_number": "540-981-8025"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "109 Kensington Pl",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "TN",
            "postal_code": "384018885",
            "country_code": "US",
            "telephone_number": "931-446-1537",
            "fax_number": "931-380-0677",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11600 W 2nd Pl",
            "address_purpose": "LOCATION",
            "city": "Lakewood",
            "state": "CO",
            "postal_code": "802281527",
            "country_code": "US",
            "telephone_number": "720-321-0000",
            "fax_number": "720-321-4165",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4050 Coon Rapids Blvd NW",
            "address_purpose": "LOCATION",
            "city": "Coon Rapids",
            "state": "MN",
            "postal_code": "554332522",
            "country_code": "US",
            "telephone_number": "612-262-1220",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6107 Pinewood Rd",
            "address_purpose": "LOCATION",
            "city": "Nunnelly",
            "state": "TN",
            "postal_code": "371372523",
            "country_code": "US",
            "telephone_number": "888-852-6672",
            "fax_number": "305-891-4228",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1015 NW 22nd Ave",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972103025",
            "country_code": "US",
            "telephone_number": "503-413-8949",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "700 Walter Reed Dr",
            "address_purpose": "LOCATION",
            "city": "Greensboro",
            "state": "NC",
            "postal_code": "274031128",
            "country_code": "US",
            "telephone_number": "336-832-9600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Atwell Rd",
            "address_purpose": "LOCATION",
            "city": "Cooperstown",
            "state": "NY",
            "postal_code": "13326",
            "country_code": "US",
            "telephone_number": "607-547-3525",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1785 Route 9",
            "address_purpose": "LOCATION",
            "city": "Halfmoon",
            "state": "NY",
            "postal_code": "120652449",
            "country_code": "US",
            "telephone_number": "518-238-6028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TALLMAN",
        "first_name": "JASON",
        "middle_name": "MATTHEW",
        "credential": "RN, APN-BC, PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-06",
        "last_updated": "2026-09-08",
        "certification_date": "2026-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "APN14483",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024186428",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61417420",
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "TN",
            "license": "RN0000135328",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "10006695",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F404803-01",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "5023466",
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "NY",
            "license": "873397-01",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "13728",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CO",
            "license": "C-APN.0100144-C-NP",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jtallman761620@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "4050 Coon Rapids Blvd NW",
            "city": "Coon Rapids",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554332522",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.