Mrs Tara Rene Blackwelder, NP-C in Cannon Afb, NM

Mrs Tara Rene Blackwelder, NP-C is a medicare enrolled "Nurse Practitioner - Family" in Cannon Afb, New Mexico. She graduated from nursing school in 2015 and has 11 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Alegent Creighton Clinic and her current practice location is 224 W D. L. Ingram Avenue, Bldg. 1408, Cannon Afb, New Mexico. You can reach out to her office (for appointments etc.) via phone at (575) 784-2778.

Mrs Tara Rene Blackwelder is licensed to practice in Nebraska (license number 115187) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1831526557.

Contact Information

	Mrs Tara Rene Blackwelder, NP-C
	224 W D. L. Ingram Avenue, Bldg. 1408, Cannon Afb, NM 88103-5014
	(575) 784-2778
	Not Available

Map and Direction

Provider's Profile

Full Name	Mrs Tara Rene Blackwelder
Gender	Female
Speciality	Nurse Practitioner
Experience	11 Years
Location	224 W D. L. Ingram Avenue, Bldg. 1408, Cannon Afb, New Mexico
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Mrs Tara Rene Blackwelder graduated from nursing school in 2015

NPI Data:

NPI Number: 1831526557
Provider Enumeration Date: 09/27/2013
Last Update Date: 12/11/2025

Medicare PECOS Information:

PECOS PAC ID: 1951830751
Enrollment ID: I20250123002047

Medical Identifiers

Medical identifiers for Mrs Tara Rene Blackwelder such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1831526557	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	115187 (Nebraska)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Chi Health Immanuel	Omaha, NE	Hospital
Chi Health Bergan Mercy	Omaha, NE	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Alegent Creighton Clinic	1951210418	890

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mrs Tara Rene Blackwelder allows following entities to bill medicare on her behalf.

Entity Name	Alegent Creighton Clinic
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1548287907 PECOS PAC ID: 1951210418 Enrollment ID: O20040407001314

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Tara Rene Blackwelder is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mrs Tara Rene Blackwelder, NP-C 27th Special Operations Medical Group, 224 W D. L. Ingram Avenue, Bldg. 1408, Cannon Afb, NM 88103-5014 Ph: (575) 784-2778	Mrs Tara Rene Blackwelder, NP-C 224 W D. L. Ingram Avenue, Bldg. 1408, Cannon Afb, NM 88103-5014 Ph: (575) 784-2778

Reviews and Comments

Nurse Practitioner Nurses in Cannon Afb, NM

Ashton Nicole Bierbrauer-martin, APRN, FNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 27th Special Operations Medical Group, 224 W D.l. Ingram Avenue, Bldg. 1408, Cannon Afb, NM 88103 Phone: 618-444-8882
Dr. Kelley Marie Henson, N.P. Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 224 W D. L. Ingram Avenue, Bldg. 1408, Cannon Afb, NM 88103 Phone: 757-225-6611
Dr. Mavis Gee, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 104 W D.l. Ingram Ave, Cannon Afb, NM 88101 Phone: 575-784-1103
Donna Ong Calla, FNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 224 W D.l. Ingram Avenue, Bldg 1408, Cannon Afb, NM 88103 Phone: 575-784-2778
Rachael Christine Auger, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 224 West D.l. Ingram Ave., Bldg. 1408, Cannon Afb, NM 88103 Phone: 575-784-2778
Miss Genevieve R Canete, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 224 W D.l. Ingram Avenue, Bldg 1408, Cannon Afb, NM 88103 Phone: 575-784-2778

Mrs Tara Rene Blackwelder, NP-C - Medicare Nurse Practitioner in Cannon Afb, NM