Tara Lyrae Swan, APN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2000162265 Issued in MO

Practice address

1502 N Jefferson St
Carrollton, MO 64633-1948

Phone

(660) 542-9998

Fax

(660) 542-9880

NPI assigned

Nov 7, 2006

Last updated

Dec 5, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MO

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

Specialty

Nurse Practitioner

Education

University of Missouri, Kansas City, School of Medicine, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

General John J Pershing Memorial Hospital AssociationGroup PAC ID 2860306750, shared by 5 NPIs, 20 clinicians

Jefferson Medical GroupGroup PAC ID 6800894379, 10 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Carroll County Memorial Hospital Hospital, Carrollton, MO, CCN 261332
• Pershing Memorial Hospital Hospital, Brookfield, MO, CCN 261307

Merit-based Incentive Payment System (MIPS)

Final score

69.76 of 100Reported as group

Quality

46.12

Promoting interoperability

100

Improvement activities

40

Cost

53.08

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ccmhhimdept@ccmhospital.cernerdirect.com
• FHIR API: https://fhir-myrecord.cerner.com/r4/9785b033-fa30-4746-84ca-c07c9380c88e/
• FHIR API: https://fhir-usa.unify.chbase.com/org/carrcmh-bfcca679
• Direct secure messaging: taraswan@ccmhospital.cernerdirect.com

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.

• Jefferson Medical Group

  • Family Medicine Physician
  • Carrollton, MO
  • NPI 1215030713
  Medicare reassignment Care Compare group NPD
• General John J Pershing Memorial Hospital Association

  dba Pershing Memorial Hospital

  • Critical Access Hospital
  • Brookfield, MO
  • NPI 1417991159
  Medicare reassignment NPD
• General John J Pershing Memorial Hospital Association

  dba Communtiy Medical Associates

  • Rural Health Clinic/Center
  • Brookfield, MO
  • NPI 1487616256
  Medicare reassignment NPD
• General John J Pershing Memorial Hospital Association

  dba Pershing Memorial Hospital

  • Primary Care Clinic/Center
  • Brookfield, MO
  • NPI 1982612461
  Medicare reassignment NPD
• Carroll County Memorial Hospital

  • Critical Access Hospital
  • Carrollton, MO
  • NPI 1528067113
  NPD
• Jefferson Medical Group

  • Rural Health Clinic/Center
  • Brunswick, MO
  • NPI 1104432806
  NPD
• Carroll County Memorial Hospital

  dba Carroll County Memorial Hospital Home Health Care Agency

  • Home Health Agency
  • Carrollton, MO
  • NPI 1205831013
  NPD (past)
• Jefferson Medical Group

  • Rural Health Clinic/Center
  • Hale, MO
  • NPI 1760772743
  NPD (past)

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

• Carroll County Memorial Hospital

  • Critical Access Hospital
  • Carrollton, MO
  • NPI 1528067113
  Care Compare affiliation
• General John J Pershing Memorial Hospital Association

  dba Pershing Memorial Hospital

  • Critical Access Hospital
  • Brookfield, MO
  • NPI 1417991159
  Care Compare affiliation

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733356800000",
    "number": "1982773586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1502 N JEFFERSON ST",
            "address_2": "ATTN: JEAN STEELE",
            "city": "CARROLLTON",
            "state": "MO",
            "postal_code": "646331948",
            "telephone_number": "660-542-1695",
            "fax_number": "660-542-0363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1502 N JEFFERSON ST",
            "city": "CARROLLTON",
            "state": "MO",
            "postal_code": "646331948",
            "telephone_number": "660-542-9998",
            "fax_number": "660-542-9880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1502 N Jefferson St",
            "address_purpose": "LOCATION",
            "city": "Carrollton",
            "state": "MO",
            "postal_code": "646331948",
            "country_code": "US",
            "telephone_number": "660-542-1695",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "807 E Broadway St",
            "address_purpose": "LOCATION",
            "city": "Brunswick",
            "state": "MO",
            "postal_code": "652361468",
            "country_code": "US",
            "telephone_number": "660-548-2012",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SWAN",
        "first_name": "TARA",
        "middle_name": "LYRAE",
        "name_prefix": "Ms.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-07",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2000162265",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "424585909",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "CCMHHIMDept@ccmhospital.cernerdirect.com",
            "affiliation": "Y",
            "affiliationName": "Carroll County Memorial Hospital",
            "address_1": "1502 N Jefferson St",
            "city": "Carrollton",
            "state": "MO",
            "country_code": "US",
            "postal_code": "646331948",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Thomas Frederick Smith, D.D.S.
• Spring Manor of Carroll County (Spring Manor Apartments)
• Spring Manor of Carroll County (Spring Manor Group Home)
• Lashawna Staton
• Debra Lorene Stedem, FNP-BC
• United Investors LP (Life Care Center of Carrollton)
• Tori D Waggoner, PHARMD
• Karla Marie Waters, LPTA

• Family Nurse Practitioner in Carrollton, MO
• Providers in Carrollton, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.