Tara Hanley, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

17674 Issued in NC

Practice address

390 S Liberty St
Winston Salem, NC 27101-5213

Phone

(336) 934-4058

Fax

(743) 255-3010

NPI assigned

Mar 29, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Complete Rehabilitation and Sports Physical Therapy, PC

  • Physical Therapist
  • Ronkonkoma, NY
  • NPI 1811097306
  NPD (past)

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

{
    "created_epoch": "1490745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787097600000",
    "number": "1043742182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 749",
            "city": "BELMONT",
            "state": "NC",
            "postal_code": "280120749",
            "telephone_number": "704-869-2088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 S LIBERTY ST",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271015213",
            "telephone_number": "336-934-4058",
            "fax_number": "743-255-3010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "675 3rd Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100175704",
            "country_code": "US",
            "telephone_number": "212-204-5190",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10945 207th St",
            "address_purpose": "LOCATION",
            "city": "Queens Village",
            "state": "NY",
            "postal_code": "114291411",
            "country_code": "US",
            "telephone_number": "718-740-2400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HANLEY",
        "first_name": "TARA",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-29",
        "last_updated": "2026-08-19",
        "certification_date": "2026-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "17674",
            "primary": true
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NY",
            "license": "021316-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Holly Crain Hanes, M.D.
• Traci Page Hanes, CRNA
• Dawanna Sheree Haney, NP
• Hanger Prosthetics & Orthotics East Inc
• Lauren Hanley
• Micheal Ashraf Hanna, MD
• Justine Hannah
• Jennifer L Hannum, MD
• Maggie Cameron Womack Hansell, M.D.
• Benjamin Hansen, PHARMD

• Occupational Therapist in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Occupational Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2026; 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.