TARA RENEE JOHNSON — NPI 1790478485 (Licensed & Credentialed Case Manager/Care Coordinator in BRANSON WEST, MO)

CMS-1500 Box 24J / 33a • NPI

1790478485

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

171M00000X

Licensed & Credentialed Case Manager/Care Coordinator

Box 32 Service Location & ZIP+4

18565 BUSINESS 13, BRANSON WEST, MO, 65737-9659

✓ 9-Digit EDI 837 ZIP+4 (65737-9659)

Practice Phone & Referral Fax

(417) 272-8064

Fax: (417) 272-0073

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1790478485 (TARA RENEE JOHNSON) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1790478485` (NPI-1 Individual Practitioner)
Provider / Legal Name	TARA RENEE JOHNSON
Plain-English Specialty	Licensed & Credentialed Case Manager/Care Coordinator NUCC Code: `171M00000X` (Case Manager/Care Coordinator)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	18565 BUSINESS 13, BRANSON WEST, MO, 65737-9659
Practice Telephone / Fax	Tel: (417) 272-8064 \| Fax: (417) 272-0073
Administrative Mailing Address	18565 BUSINESS 13, BRANSON WEST, MO, 65737-9659
Enumeration & Last Sync	Enumerated: 2023-05-30 \| CMS Record Updated: 2023-05-30

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

18565 BUSINESS 13, BRANSON WEST, MO, 65737-9659

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Plain-English Taxonomy & CMS Crosswalk (171M00000X)

What Does Taxonomy Code 171M00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 171M00000X translates to:
"Licensed & Credentialed Case Manager/Care Coordinator"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Case Manager/Care Coordinator for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (TARA RENEE JOHNSON)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`171M00000X` — Case Manager/Care Coordinator Plain English: Licensed & Credentialed Case Manager/Care Coordinator	State: MO \| License: `2009016264` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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TARA RENEE JOHNSON (NPI #1790478485)