Individual provider Active NPI

Tara May Lancour, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Fairhope, AL
National Provider Identifier
1982391652
Registry record updated Apr 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1-164682 Issued in AL
Practice address
372 Greeno Rd S
Fairhope, AL 36532-1916
Phone
(251) 450-2211
NPI assigned
Apr 21, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1-164682 AL Primary

Addresses

Primary practice location

372 Greeno Rd S
Fairhope, AL 36532-1916

Mailing address

8016 Deerwood Dr S
Daphne, AL 36526-7281
Phone (810) 835-1521

Other practice location 1

201 E Camphor Ave
Foley, AL 36535-2819
Phone (251) 929-5410

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20230712003872 AL Practitioner - Nurse Practitioner 3173983954 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of South Alabama College of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Altapointe Health Systems IncGroup PAC ID 1052224052, 97 clinicians

Practice addresses (Care Compare)

372 S Greeno Rd
Fairhope, AL 36532-1916
Phone (251) 450-2211

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Altapointe Health Systems, Inc. CurrentSince May 8, 2023 Accepting new patients
Altapointe Health Systems, Inc. CurrentSince May 8, 2023 Accepting new patients

Locations

372 Greeno Rd S
Fairhope, AL 36532
Phone (251) 927-2871

201 E Camphor Ave
Foley, AL 36535
Phone (251) 929-5410

2400 Gordon Smith Dr
Mobile, AL 36617
Phone (251) 305-4660

5750A Southland Dr
Mobile, AL 36693
Phone (251) 450-5901

Organizations & group practices 2

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": "1682035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682035200000",
    "number": "1982391652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8016 DEERWOOD DR S",
            "city": "DAPHNE",
            "state": "AL",
            "postal_code": "365267281",
            "telephone_number": "810-835-1521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "372 GREENO RD S",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "365321916",
            "telephone_number": "251-450-2211"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 E Camphor Ave",
            "address_purpose": "LOCATION",
            "city": "Foley",
            "state": "AL",
            "postal_code": "365352819",
            "country_code": "US",
            "telephone_number": "251-929-5410",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANCOUR",
        "first_name": "TARA",
        "middle_name": "MAY",
        "name_prefix": "Mrs.",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-21",
        "last_updated": "2023-04-21",
        "certification_date": "2023-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AL",
            "license": "1-164682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairhope, AL

Sources for this page

Verify at the official NPI Registry.