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TARA LISA WAGGONER FNP, APN-BC
NPI 1568515930
Nurse Practitioner - Family in Jonesboro, AR

Active since January 19, 2007PECOS Enrolled
333 STADIUM BLVD., SUITE B, JONESBORO, AR 72401(870) 972-2054 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Tara Lisa Waggoner Fnp, Apn-bc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TARA LISA WAGGONER FNP, APN-BC (NPI 1568515930) is an individual family provider in Jonesboro, Arkansas, licensed in Arkansas (A01852) and active in the NPI registry since January 2007. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1568515930
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameTARA LISA WAGGONERCredential: FNP, APN-BC
Location Address333 STADIUM BLVD., SUITE BJonesboro, AR 72401
Mailing Address4203 Sandstone DrJonesboro, AR 72401-7833 · (870) 910-0436
Phone(870) 972-2054
Sole ProprietorNo
Enumeration DateJanuary 19, 2007
Last NPPES UpdateJuly 8, 2007
✔ NPI 1568515930 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in AR · A01852
333 STADIUM BLVD., Jonesboro, AR 72401
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Other Identifiers 1

Medicare UPINQ42646AR

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tara Lisa Waggoner Fnp, Apn-bc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 72401 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$79.72 typical visit price
range $51.36 – $157.74
Typical copayment $19.93 (range $12.84 – $39.43)
Most-billed visit code 99203
Established Patient
$91.63 typical visit price
range $16.16 – $128.77
Typical copayment $22.90 (range $4.04 – $32.19)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Tara Waggoner's NPI number?

The NPI number for Tara Waggoner is 1568515930. It was assigned to this individual provider in the NPPES registry on January 19, 2007.

Where is Tara Waggoner located?

Tara Waggoner practices at 333 Stadium Blvd. Suite B, Jonesboro, AR 72401. The listed phone number is (870) 972-2054.

What is Tara Waggoner's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Tara Waggoner enrolled in Medicare?

Yes. Tara Waggoner is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Tara Waggoner was last updated on July 8, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.