Individual ProviderTara BairdNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address1919 N Amidon Ave Ste 130, Wichita, KS 67203-2118(316) 660-7675(316) 660-7600PECOS EnrollmentBased on the most recent information from CMS, provider Tara Baird is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1124495049Provider TypeIndividualFull NameBaird, TaraCredentialAPRNGenderFemaleSole ProprietorNoEnumeration Date8/26/2015Last Updated3/23/2018Contact InformationPractice LocationPractice Address1919 N Amidon Ave Ste 130, Wichita, KS 67203-2118Phone(316) 660-7675Fax(316) 832-1571Mailing LocationMailing Address271 W 3rd St N, Ste 600, Wichita, KS 67202-1223Phone(316) 660-7600Fax(316) 941-5075Provider TaxonomiesCodeDescriptionLicenseCode363L00000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense78054KansasCode163WG0000XDescriptionRegistered NurseNursing Service ProvidersLicense116813Kansas