TARIS GONZALEZ (NPI# 1821290743) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821290743 |
| Entity Type | Individual |
| Full Name | TARIS GONZALEZ |
| Credential | NP |
| Practice Address |
8391 S Shady Trail Dr Pendleton IN 46064-8652 |
| Practice Telephone | 3175072395 |
| Mailing Telephone | 3177430009 |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2019-08-29 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 71001601A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
71001601 | IN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | RR MEDICARE PTAN | P01170026 | 01 |
| IN | 200460280 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 135 Jordan Rd, Indianapolis, IN 462174003 | 8002606145 | |
| 625 S Tillotson Ave, Muncie, IN 473044449 | 8002606145 | |
| 8856 South St, Fishers, IN 460382911 | 3175161177 |
| Street Address |
8391 S SHADY TRAIL DR |
| City | PENDLETON |
| State | IN |
| Zip Code | 46064-8652 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437622701 | Gsg Pride Healthcare LLC | Clinic/Center | 8391 S Shady Trail Dr, Pendleton, IN 46064-8652 | 2019-01-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912214727 | Classic Sleepcare, LLC | Durable Medical Equipment & Medical Supplies | 138 West State Street, Suite #4, Pendleton, IN 46064 | 2010-09-01 |
| 1629239355 | Stephanie Jane Russ | Family Medicine | 1251 S Huntzinger Blvd, Suite 100, Pendleton, IN 46064 | 2008-06-25 |
| 1003004219 | Hamilton-madison, Inc. | Durable Medical Equipment & Medical Supplies | 105 1/2 E. State Street, Pendleton, IN 46064 | 2007-10-12 |
| 1518019637 | Pendleton Emergency Ambulance Inc | Ambulance | 100 S Broadway, Pendleton, IN 46064 | 2007-01-17 |
| 1487755716 | Anna Marie Tallant | Counselor | 131 N Pendleton Ave, Suite A, Pendleton, IN 46064 | 2006-09-26 |
| 1336242700 | Jennifer A Neise | Dentist | 3132 W. State Road 38, Pendleton, IN 46064 | 2006-09-07 |
| 1366900599 | Megan Daberko | Registered Nurse | 1251 Huntzinger Blvd Ste 100, Pendleton, IN 46064 | 2019-03-06 |
| 1821594672 | Jean Castro | Registered Nurse | 1251 Huntzinger Blvd Ste 100, Pendleton, IN 46064 | 2018-04-02 |
| 1013002310 | Kenneth U Lau | Dentist | 210 East Water Street, Pendleton, IN 46064 | 2006-10-03 |
| 1912955832 | Indiana Tmj Treatment Center | Dentist | 210 East Water Street, Pendleton, IN 46064-0206 | 2006-05-04 |
| Find all providers in zip 46064 | ||||
| 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 |
|---|---|---|---|---|
| 1629069893 | Lynn Marie Lieuallen | Nurse Practitioner | 2461 Sw Perkins Ave, Pendleton, OR 97801-4301 | 2005-11-04 |
| 1942670922 | Colleen Thurman | Nurse Practitioner | 46314 Timine Way, Pendleton, OR 97801 | 2015-10-02 |
| 1548284391 | Teri Lee Rosselle | Nurse Practitioner | 2461 Sw Perkins Ave, Pendleton, OR 97801-4301 | 2006-07-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538769948 | Amy Renee Bradley | Nurse Practitioner | 10404 Cerulean Dr, Noblesville, IN 46060-7676 | 2020-10-27 |
| 1083213607 | Medihealth Primary Care LLC | Nurse Practitioner | 2345 W Franklin St Ste 102, Evansville, IN 47712-5100 | 2020-10-23 |
| 1891394599 | Laury Farrell | Nurse Practitioner | 6017 Stoney Creek Dr, Fort Wayne, IN 46825-4410 | 2020-10-22 |
| 1255930657 | Caitlyn Shuck | Nurse Practitioner | 2641 Marsh Hawk Dr, Greenwood, IN 46143-5749 | 2020-10-19 |
| 1730787599 | Crystal Neal | Nurse Practitioner | 4430 Keeneland Ln Unit 202, Fort Wayne, IN 46845-1985 | 2020-10-14 |
| 1285240390 | Amy D Perry | Nurse Practitioner | 728 N Cross Pointe Blvd # 102, Evansville, IN 47715-9163 | 2020-09-23 |
| 1013523588 | Amy Deion Stitt | Nurse Practitioner | 738 E 200 N, Warsaw, IN 46582-4658 | 2020-09-21 |
| 1881200152 | Positive Energy Health Center LLC | Nurse Practitioner | 5023 E 56th St Ste 130, Indianapolis, IN 46226-1471 | 2020-09-21 |
| 1417574013 | Hellen Gathesha | Nurse Practitioner | 2123 W Irvington Dr, South Bend, IN 46614 | 2020-06-30 |
| 1821615485 | Denise Michelle Alexander | Nurse Practitioner | 815 West 2nd Street, Bloomington, IN 47403-2212 | 2020-06-30 |
| Find all providers with the same taxonomy | ||||
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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.