TARA SIPE (NPI# 1164813481) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164813481 |
| Entity Type | Individual |
| Full Name | TARA SIPE |
| Practice Address |
7910 W Jefferson Blvd Ste 112 Fort Wayne IN 46804-4159 |
| Mailing Address |
3926 New Vision Dr Bldg H Fort Wayne IN 46845-1712 |
| Practice Telephone | 2609697121 |
| Mailing Telephone | 2602668213 |
| Mailing Fax Number | 2602668213 |
| Enumeration Date | 2015-02-09 |
| Last Update Date | 2016-12-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 71005342A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
7910 W JEFFERSON BLVD STE 112 |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46804-4159 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205117454 | Deanna L. Massie | Clinical Nurse Specialist | 7910 W Jefferson Blvd Ste 112, Fort Wayne, IN 46804-4159 | 2011-09-01 |
| 1932673167 | Rebecca Ruth Krull Brown | Nurse Practitioner | 7910 W Jefferson Blvd Ste 112, Fort Wayne, IN 46804-4159 | 2019-01-22 |
| 1295005395 | Neal Agee | Surgery | 7910 W Jefferson Blvd Ste 112, Fort Wayne, IN 46804-4159 | 2012-01-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396350344 | Derek Mumaw | Physical Therapist | 8420 Illinois Rd, Fort Wayne, IN 46804 | 2020-09-15 |
| 1942840228 | Erin M Mason | Behavior Technician | 5601 Coventry Ln, Fort Wayne, IN 46804 | 2020-01-14 |
| 1346880879 | Emily A Abdalla | Behavior Technician | 5601 Coventry Ln., Fort Wayne, IN 46804 | 2020-01-13 |
| 1083265433 | Fort Wayne Endodontics | Dentist | 9407 Illinois Rd, Fort Wayne, IN 46804 | 2019-09-26 |
| 1689140949 | Harrison Dental Group II, LLC | Dentist | 1333 Getz Rd, Fort Wayne, IN 46804 | 2018-10-15 |
| 1346731908 | Erin Nicole Zimmerman | Nurse Practitioner | 10170 Illinois Rd # 14, Fort Wayne, IN 46804 | 2018-05-19 |
| 1417446022 | Mary Harrington | Physical Therapist | 3320 Copper Hill Run, Fort Wayne, IN 46804 | 2018-05-09 |
| 1942701214 | Joshawa Todd Torres | Marriage & Family Therapist | 5651 Coventry Ln # 116, Fort Wayne, IN 46804 | 2018-02-22 |
| 1194235408 | Mitchell Kory Meyer | Specialist/Technologist | 9125 Yellow Tree Ct, Fort Wayne, IN 46804 | 2017-10-02 |
| 1902324916 | Emily Rene Sagstetter | Specialist/Technologist | 6034 Liberty Glade Ct, Fort Wayne, IN 46804 | 2017-08-30 |
| Find all providers in zip 46804 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891394599 | Laury Farrell | Nurse Practitioner | 6017 Stoney Creek Dr, Fort Wayne, IN 46825-4410 | 2020-10-22 |
| 1730787599 | Crystal Neal | Nurse Practitioner | 4430 Keeneland Ln Unit 202, Fort Wayne, IN 46845-1985 | 2020-10-14 |
| 1225668312 | Kathleen Vanderreyden | Nurse Practitioner | 3005 E State Blvd, Fort Wayne, IN 46805-4736 | 2020-01-17 |
| 1043703903 | Kara Stackhouse | Nurse Practitioner | 11050 Parkview Plaza Drive, Fort Wayne, IN 46845 | 2018-06-14 |
| 1275980690 | April Anderson | Nurse Practitioner | 6920 Pointe Inverness Way Ste 120, Fort Wayne, IN 46804-7926 | 2016-05-16 |
| 1922470970 | Jennifer Carol Littke | Nurse Practitioner | 6326 Constitution Dr, Fort Wayne, IN 46804-1518 | 2015-10-28 |
| 1275956054 | Andrea N Lahrman | Nurse Practitioner | 11123 Parkview Plaza Dr Ste 106, Fort Wayne, IN 46845-1707 | 2014-01-29 |
| 1417213729 | Laura Beth Baker | Nurse Practitioner | 5750 Falls Drive, Fort Wayne, IN 46804-7147 | 2012-04-11 |
| 1447572441 | Kathryn L Smith | Nurse Practitioner | 11104 Parkview Circle Dr Ste 20, Fort Wayne, IN 46845-1733 | 2010-02-18 |
| 1316180144 | Braden M Butterfield Mckinley | Nurse Practitioner | 2101 E Coliseum Blvd Rm 234, Fort Wayne, IN 46805-1445 | 2009-04-09 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46804 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.