NPIMap

Individual provider Active NPI

Tara Lambert Moncus, DMD

  • Pediatric Dentistry
  • Rainsville, AL
National Provider Identifier
1003811241
Registry record updated Nov 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
5126 Issued in AL
Practice address
371 McCurdy Ave S
Rainsville, AL 35986-5215
Phone
(256) 638-3000
NPI assigned
Jun 15, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 5126 AL Primary

Addresses

Primary practice location

371 McCurdy Ave S
Rainsville, AL 35986-5215

Mailing address

PO Box 1069
Rainsville, AL 35986-1069
Phone (256) 638-3000

Other identifiers 1

IdentifierTypeStateIssuer
009932625MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5126ALMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Rainsville Pediatric Dental Village Pediatric Dentistry Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1118793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259539200000",
    "number": "1003811241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1069",
            "city": "RAINSVILLE",
            "state": "AL",
            "postal_code": "359861069",
            "telephone_number": "256-638-3000",
            "fax_number": "256-638-3099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "371 MCCURDY AVE S",
            "city": "RAINSVILLE",
            "state": "AL",
            "postal_code": "359865215",
            "telephone_number": "256-638-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONCUS",
        "first_name": "TARA",
        "middle_name": "LAMBERT",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-15",
        "last_updated": "2009-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "AL",
            "license": "5126",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009932625",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rainsville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.