TABATHYA LANE APRN
NPI 1528896396
Nurse Practitioner - Psychiatric/Mental Health in Kingston, OK
About Tabathya Lane Aprn NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
TABATHYA LANE APRN (NPI 1528896396), doing business as Evergrace Health And Wellness, is a healthcare organization registered as a psychiatric/mental health in Kingston, Oklahoma and active in the NPI registry since July 2024. The organization lists Tabathya Starr Taliaferro, Sole Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Other Names 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Tabathya Lane Aprn is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Tabathya Lane Aprn, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Tabathya Lane Aprn's NPI number?
The NPI number for Tabathya Lane Aprn is 1528896396. It was assigned to this organization in the NPPES registry on July 23, 2024. The provider is doing business as Evergrace Health And Wellness.
Where is Tabathya Lane Aprn located?
Tabathya Lane Aprn is located at 9118 Buckaloo Bend Rd, Kingston, OK 73439. The listed phone number is (580) 504-3090.
What is Tabathya Lane Aprn's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Tabathya Lane Aprn enrolled in Medicare?
Yes. Tabathya Lane Aprn is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Tabathya Lane Aprn?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Tabathya Lane Aprn. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Tabathya Lane Aprn accept?
Health plans from Blue Cross and Blue Shield of Oklahoma list Tabathya Lane Aprn as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Tabathya Lane Aprn was last updated on July 31, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Tabathya Lane Aprn · NPI 1528896396
Psychiatric/Mental Health organization in Kingston, Oklahoma. Organization record, active in the CMS NPPES registry since July 23, 2024.
## Identity
- **NPI:** 1528896396 (Entity type: Organization)
- **Enumerated:** July 23, 2024
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **Also known as:** EVERGRACE HEALTH AND WELLNESS (Doing Business As)
- **Organization subpart:** No
- **Authorized official:** Tabathya Taliaferro, SOLE OWNER
## Practice location
- **Address:** 9118 BUCKALOO BEND RD, Kingston, OK 73439-2021
- **Phone:** (580) 504-3090
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 31, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1528896396) · Data from the CMS NPPES public registry.