Nicholas Henry Tannenbaum

Primary specialty

Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X

License

2024-01464 Issued in NC

Practice address

2817 Rock Merritt Ave
Fort Bragg, NC 28310-0004

Phone

(910) 907-8922

Fax

(910) 907-6069

NPI assigned

Jun 7, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Nicholas Tannerbaum Other name

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Emergency Medicine

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emergency Coverage LLCGroup PAC ID 3072412592, 761 clinicians

Hoke Emergency Group, PCGroup PAC ID 7214200146, 44 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Central Carolina Hospital Hospital, Sanford, NC, CCN 340020
• Cape Fear Valley Hoke Hospital Hospital, Raeford, NC, CCN 340188

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Hoke Emergency Group, PC

  • Emergency Medicine Physician
  • Raeford, NC
  • NPI 1003337528

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Emergency Coverage, LLC

  • Family Medicine Physician
  • Newport, TN
  • NPI 1427005008

  NC, Single Specialty

  Medicare reassignment Care Compare group NPD
• Bladen Medical Associates

  • Nurse Practitioner
  • Bladenboro, NC
  • NPI 1316068307
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• DLP Central Carolina Medical Center LLC

  • General Acute Care Hospital
  • Sanford, NC
  • NPI 1902836943
  Care Compare affiliation
• Hoke Healthcare LLC

  • General Acute Care Hospital
  • Raeford, NC
  • NPI 1750788238
  Care Compare affiliation

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

{
    "created_epoch": "1623024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769731200000",
    "number": "1013584382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2817 ROCK MERRITT AVE",
            "city": "FORT BRAGG",
            "state": "NC",
            "postal_code": "283100001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2817 ROCK MERRITT AVE",
            "city": "FORT BRAGG",
            "state": "NC",
            "postal_code": "283100004",
            "telephone_number": "910-907-8922",
            "fax_number": "910-907-6069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANNENBAUM",
        "first_name": "NICHOLAS",
        "middle_name": "HENRY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-07",
        "last_updated": "2026-01-30",
        "certification_date": "2026-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "GA",
            "license": "12918",
            "primary": false
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "NC",
            "license": "2024-01464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "FTLiberty",
            "affiliation": "N",
            "address_1": "2817 Rock Merritt Ave",
            "city": "APO",
            "state": "AA",
            "country_code": "US",
            "postal_code": "283100004",
            "country_name": "United States",
            "address_type": "MIL"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Augusta",
            "affiliation": "N",
            "address_1": "1120 15th St",
            "city": "Augusta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "309120004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "NICHOLAS",
            "last_name": "TANNERBAUM",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Karen L Szafrajda, MSN - FNP-C
• Renee Hursey Talbert, AU.D.
• Jessica Tan, DPT
• Michael James Tankovich, PT, DPT, ATC
• Austin T Tannenbaum, MD
• Elisabeth R Tavares
• Jasmin Taylor, LCSW, LCAS
• Mark A. Taylor, PH.D.
• Shawn Frank Taylor, MD
• Stephanie L Taylor

• Emergency Medical Services (Emergency Medicine) Physician in Fort Bragg, NC
• Providers in Fort Bragg, NC by specialty
• Emergency Medical Services (Emergency Medicine) Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.