| Dr Taryn Kline Fernandes, MD | |
|
163 11th Ave, Union Grove, WI 53182-1282 | |
| (530) 356-6739 | |
| Not Available |
| Full Name | Dr Taryn Kline Fernandes |
|---|---|
| Gender | Female |
| Speciality | General Practice |
| Experience | 12 Years |
| Location | 163 11th Ave, Union Grove, Wisconsin |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508396292 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | 153791 (Florida) | Primary |
| 207R00000X | Internal Medicine | 125.071000 (Illinois) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Dunes Hospice Llc | Valparaiso, IN | Hospice |
| Paradigm Living Concepts | Indianapolis, IN | Hospice |
| Community Hospital Of Bremen Inc | Bremen, IN | Hospital |
| La Porte Hospital | La porte, IN | Hospital |
| Golden Living Center-fountainview Terrace | La porte, IN | Nursing home |
| Belltower Health & Rehabilitation Center | Granger, IN | Nursing home |
| Golden Living Center-laporte | La porte, IN | Nursing home |
| Hamilton Grove | New carlisle, IN | Nursing home |
| Woodland Manor | Elkhart, IN | Nursing home |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Eventus Ecs, Inc | 2163969650 | 230 |
| Extended Care Specialists, Inc | 2466407713 | 271 |
| Entity Name | Extended Care Specialists, Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1134146079 PECOS PAC ID: 2466407713 Enrollment ID: O20050318000726 |
| Entity Name | Eventus Wholehealth Midwest Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1386252757 PECOS PAC ID: 4183040470 Enrollment ID: O20200818000277 |
| Entity Name | Theoria Medical |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1609362375 PECOS PAC ID: 5395098339 Enrollment ID: O20211209000803 |
| Entity Name | Eventus Ecs, Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1073353496 PECOS PAC ID: 2163969650 Enrollment ID: O20240801002542 |
| Entity Name | Eventus Wh Midwest Care, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1588481717 PECOS PAC ID: 1456880632 Enrollment ID: O20250203001519 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Taryn Kline Fernandes, MD 163 11th Ave, Union Grove, WI 53182-1282 Ph: (530) 356-6739 | Dr Taryn Kline Fernandes, MD 163 11th Ave, Union Grove, WI 53182-1282 Ph: (530) 356-6739 |