Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1134226699 Individual Practitioner Female Practitioner

Dr. Tara Lorence Vanbennekom , DO

Pediatrics • St. Augustine, FL

Professional Overview & Biography Verified Profile Summary

Dr. Tara Vanbennekom, DO is a registered healthcare professional specializing in Pediatrics in St. Augustine, FL. Practice services are available at 304 KINGSLEY LAKE DRIVE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

304 Kingsley Lake Drive
Suite #603

St. Augustine, FL 32092

Telephone 9048245437
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in St. Augustine, FL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 22.2 Yrs
Regional Practice Density
17 Specialists

Practicing in St. Augustine, FL (4160 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License FL OS 8054

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

6 Associated Practitioners
Jennifer Angel , APRN

Nurse Practitioner - Pediatrics

NPI 1255415725

Advanced Practice Registered Nurse

Victoria Miller , PA-C

Physician Assistant

NPI 1316946866

Physician Assistant (Certified)

NPI 1477596377

Doctor of Medicine (M.D.)

Cyndie Hatcher

Pediatrics

NPI 1538588785
NPI 1598846339

Doctor of Medicine (M.D.)

Natasha Jno Baptiste

Nurse Practitioner - Family

NPI 1811343791

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 08, 2007

Registered at 304 KINGSLEY LAKE DRIVE, SUITE #603, ST. AUGUSTINE, FL 32092 (Tel: 9048245437)

📍
Updated Business Mailing Address July 08, 2007

Registered at 201 ST. JOHNS FOREST BLVD, JACKSONVILLE, FL 32259 (Tel: 9048245796)

👤
Provider Name / Credentials Updated July 08, 2007

Recorded as TARA VANBENNEKOM, DO

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Pediatrics (License #OS 8054 in FL)

🟢
Initial NPI Registration & Enumeration September 19, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1134226699
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 19, 2006
Last Update: July 08, 2007
Sole Proprietor: No

Mailing Address

201 St. Johns Forest Blvd

Jacksonville, FL 32259

Phone: 9048245796

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.