MISS TARA NICOLE ROGERS (NPI# 1831409135) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831409135 |
| Entity Type | Individual |
| Full Name | MISS TARA NICOLE ROGERS |
| Credential | P.A. |
| Practice Address |
550 Club Ln Conway AR 72034 |
| Mailing Address |
550 Club Ln Conway AR 72034-3681 |
| Practice Telephone | 5013291510 |
| Practice Fax Number | 5013272495 |
| Mailing Telephone | 5013291510 |
| Mailing Fax Number | 5013272495 |
| Enumeration Date | 2010-10-20 |
| Last Update Date | 2019-07-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA-513 | AR | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | LICENSE | PA513 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1605 W Main St, Russellville, AR 728012719 | 4798909292 | 4798906962 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083014344 | Tara Rogers | Specialist/Technologist | 131 College Cir, Swainsboro, GA 30401-3643 | 2014-08-23 |
| 1538795158 | Tara Rogers | Registered Nurse | 1924 Alcoa Hwy, Knoxville, TN 37920-1511 | 2020-03-15 |
| 1114564812 | Tara Kay Rogers | Obstetrics & Gynecology | 201 23rd Ave N, Nashville, TN 37203-1501 | 2019-12-02 |
| 1669855417 | Tara Rogers | Occupational Therapist | 10133 Sherrill Blvd, Knoxville, TN 37932-3347 | 2015-06-29 |
| 1457750556 | Tara Rogers | Pharmacist | 400 Shallowford Rd Nw, Gainesville, GA 30504-4152 | 2014-08-14 |
| 1154642270 | Tara Rogers | Physical Therapist | 3500 W Davis St Ste 150b, Conroe, TX 77304-1811 | 2010-06-14 |
| 1134375793 | Tara Lynn Rogers | Registered Nurse | 804 N Parkway, Jackson, TN 38305-3058 | 2008-08-14 |
| Street Address |
550 CLUB LN |
| City | CONWAY |
| State | AR |
| Zip Code | 72034 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780748491 | Christopher Lee Throneberry | Physical Therapist | 550 Club Ln, Suite 2, Conway, AR 72034-3681 | 2006-12-20 |
| 1720620818 | Emily L Mckinney | Physician Assistant | 550 Club Ln, Conway, AR 72034-3681 | 2019-10-10 |
| 1679052559 | Aaron Baxter | Clinical Nurse Specialist | 550 Club Ln, Conway, AR 72034-3681 | 2018-08-10 |
| 1023532066 | Mattison Marie Weaver | Specialist/Technologist | 550 Club Ln, Conway, AR 72034-3681 | 2017-08-01 |
| 1851829667 | Alecia Elkins | Occupational Therapist | 550 Club Ln, Conway, AR 72034-3681 | 2017-05-24 |
| 1144766288 | Daniel Green | Physician Assistant | 550 Club Ln, Conway, AR 72034-3681 | 2017-01-12 |
| 1053765180 | Mitchell Reynolds | Occupational Therapist | 550 Club Ln, Conway, AR 72034-3681 | 2016-04-14 |
| 1386004653 | Charles Sibley | Physical Therapist | 550 Club Ln, Conway, AR 72034-3681 | 2016-03-01 |
| 1831575588 | Stewart Andrew Tackett | Specialist/Technologist | 550 Club Ln, Conway, AR 72034-3681 | 2015-08-05 |
| 1952797078 | Augusta Jean Nelson | Specialist/Technologist | 550 Club Ln, Suite 2, Conway, AR 72034-3681 | 2015-04-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013563758 | Shelby M Perez | Case Manager/Care Coordinator | 3240 Stermer Rd, Conway, AR 72034 | 2019-08-16 |
| 1467932772 | Faith J Parfait | Licensed Practical Nurse | 1352 Watkins St, Conway, AR 72034 | 2018-08-16 |
| 1043790611 | David Adam Steinfeld | Nurse Practitioner | 855 S German Ln Ste 1, Conway, AR 72034 | 2018-08-14 |
| 1245728484 | Conway Behavioral Health, LLC | Psychiatry & Neurology | 2255 Sturgis Rd, Conway, AR 72034 | 2018-04-24 |
| 1972007292 | Eldercare of Arkansas IIi, Inc. | Assisted Living Facility | 1306 S. Donaghey, Conway, AR 72034 | 2018-03-21 |
| 1528561404 | Kouhei Kobayashi | Specialist/Technologist | 2201 Moix Blvd., Apt. 908, Conway, AR 72034 | 2018-03-16 |
| 1780191015 | Sydnie Thessing | Nurse Practitioner | 605 Dave Ward Drive #105, Conway, AR 72034 | 2018-01-09 |
| 1508371865 | Ebony Latreace Charleston | Case Manager/Care Coordinator | 3240 Stermer Road, Conway, AR 72034 | 2017-12-08 |
| 1689190647 | Denise Annette Aikman | Dentist | 1210 Hogan Lane, Suite 200, Conway, AR 72034 | 2017-08-21 |
| 1134669138 | Hortons Orthotic Lab, Inc. | Prosthetic/Orthotic Supplier | 635 Dave Ward, Suite 103, Conway, AR 72034 | 2017-02-24 |
| Find all providers in zip 72034 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255622122 | Shan Fu | Physician Assistant | 2376 Cypress Cir, Suite 300, Conway, SC 29526-8964 | 2011-04-27 |
| 1336327741 | Christopher A Kearney | Physician Assistant | 2376 Cypress Cir, Ste 300, Conway, SC 29526-8995 | 2008-02-07 |
| 1033278049 | Keith C Reinwald | Physician Assistant | 2376 Cypress Cir Ste 300, Conway, SC 29526-8995 | 2006-12-06 |
| 1043385123 | Douglas T. Vick | Physician Assistant | 2376 Cypress Cir Ste 300, Conway, SC 29526-8995 | 2006-11-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033650817 | Dickson Orthopedics, Pa | Physician Assistant | 1416 E Matthews, Suite 200, Jonesboro, AR 72401-4632 | 2017-03-14 |
| 1912455387 | Anthony D Long Jr. | Physician Assistant | 17 Mockingbird Ln, Pine Bluff, AR 71603-6107 | 2016-09-14 |
| 1215233887 | Joshua Anthony Trinkle | Physician Assistant | 224 W. Erie Ave, Harrison, AR 72601 | 2011-01-31 |
| 1831391655 | Mandy Suzanne Mooneyham | Physician Assistant | 3053 N College Ave, Fayetteville, AR 72703-3417 | 2007-06-04 |
| 1487252755 | David M Street | Physician Assistant | 2010 Active Way, Benton, AR 72022-9267 | 2020-10-09 |
| 1407460843 | Alexandra Paige Brown | Physician Assistant | 1695 E Rainforest Rd, Fayetteville, AR 72703-5385 | 2020-09-02 |
| 1881158517 | Jordan Lane Milam | Physician Assistant | 5 Saint Vincent Cir Ste 100, Little Rock, AR 72205-5415 | 2019-01-28 |
| 1790252286 | Allison Henry | Physician Assistant | 4301 W Markham St, Little Rock, AR 72205-7101 | 2018-11-01 |
| 1649755133 | Hillary Michelle Mayberry | Physician Assistant | 4301 W Markham St, Little Rock, AR 72205-7101 | 2018-10-01 |
| 1013417518 | Corey Carver | Physician Assistant | 1000 S 52nd St, Rogers, AR 72758-8610 | 2018-02-20 |
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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.