Tacara Nichole Anderson, APRN, FNP-C
Individual provider Active NPI Family Nurse Practitioner · Clayton, NC
NPI 1053922294 · NPPES record last updated Jan 3, 2026
Key facts
- NPI
- 1053922294
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 5016648 (NC)
- Practice address
- 11618 Clayton Blvd
Clayton, NC 27520-2275 - Phone
- (919) 416-8010
- NPI assigned
- Aug 12, 2020
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 16
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Daniel Funsch Jr MD PC
Dr Rebman Medical PA
Ivy Medical Group PLLC
Daniel Funsch Jr MD Professional Corporation
Practice addresses (Care Compare)
103 Hospital Loop NE
Albuquerque, NM 87109-2115
Phone (212) 734-6621
11 Dairy LN
Fredericksburg, VA 22405-2663
Phone (212) 734-6621
1390 N Poplar Fork Rd
Hurricane, WV 25526-7112
Phone (212) 734-6621
1507 S Tuttle Ave
Sarasota, FL 34239-2608
Phone (212) 734-6621
20 Maitland St
Concord, NH 03301-3534
Phone (212) 734-6621
228 Smith Chapel Rd
Mount Olive, NC 28365-1917
Phone (212) 734-6621
2710 Gateway Oaks Dr
Suite 150N
Sacramento, CA 95833-3502
Phone (817) 966-0621
596 Sheldon Rd
Saint Albans, VT 05478-8011
Phone (212) 734-6621
715 E King St
Seaford, DE 19973-3505
Phone (212) 734-6621
9200 Franklin Square Dr
Baltimore, MD 21237-4458
Phone (212) 734-6621
Hospital & facility affiliations
- Doctors Community Rehabilitation and Patient Care
- Larkin Chase Center
- Seaford Center
- Oceanside Skilled Nursing and Rehabilitation
- The Rehabilitation Center of Albuquerque
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (17 enrollments) in VA, DC, NC, FL, CO, MI, NH, DE, MD, VT, WV, PA, NY, NM, MO, CA, WA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210325001104 | VA | Practitioner - Nurse Practitioner | 4284041914 | Reassigns benefits to 3 organizations |
| I20210325001490 | DC | Practitioner - Nurse Practitioner | 4284041914 | |
| I20230527000296 | NC | Practitioner - Nurse Practitioner | 4284041914 | Reassigns benefits to 5 organizations |
| I20241016000630 | FL | Practitioner - Nurse Practitioner | 4284041914 | Reassigns benefits to 5 organizations |
| I20241023001530 | CO | Practitioner - Nurse Practitioner | 4284041914 | Reassigns benefits to 1 organization |
| I20241206002166 | MI | Practitioner - Nurse Practitioner | 4284041914 | |
| I20241206002585 | NH | Practitioner - Nurse Practitioner | 4284041914 | Reassigns benefits to 3 organizations |
| I20241212000154 | DE | Practitioner - Nurse Practitioner | 4284041914 | Reassigns benefits to 3 organizations |
| I20241212000241 | MD | Practitioner - Nurse Practitioner | 4284041914 | Reassigns benefits to 2 organizations |
| I20241219003734 | VT | Practitioner - Nurse Practitioner | 4284041914 | Reassigns benefits to 4 organizations |
| I20250107001173 | WV | Practitioner - Nurse Practitioner | 4284041914 | Reassigns benefits to 4 organizations |
| I20250203002916 | PA | Practitioner - Nurse Practitioner | 4284041914 | |
| I20250221003356 | NY | Practitioner - Nurse Practitioner | 4284041914 | Reassigns benefits to 1 organization |
| I20250224001020 | NM | Practitioner - Nurse Practitioner | 4284041914 | Reassigns benefits to 2 organizations |
| I20250304000925 | MO | Practitioner - Nurse Practitioner | 4284041914 | Reassigns benefits to 1 organization |
| I20250310003184 | CA | Practitioner - Nurse Practitioner | 4284041914 | Reassigns benefits to 1 organization |
| I20260303003380 | WA | Practitioner - Nurse Practitioner | 4284041914 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AC003520 | MD | MD | Family Nurse Practitioner |
| 5016648 | NC | MD | Family Nurse Practitioner |
| 0024180193 | VA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dr Rebman BH LLC | Single Specialty | Current |
Accepting new patients |
| Post Acute Specialists, LLC | Single Specialty | Current |
Accepting new patients |
| Dr Medical Services PC | Single Specialty | Current |
Accepting new patients |
| Texas Post Acute Specialists, PA | Single Specialty | Current |
Accepting new patients |
| Dr Vezza Medical Services PC | Single Specialty | Current |
Accepting new patients |
| Mi Post Acute Specialists PC | Single Specialty | Current |
Accepting new patients |
| Dr Rebman Medical PA | Single Specialty | Current |
Accepting new patients |
| Daniel Funsch Jr, M.D., Professional Corporation | Single Specialty | Current |
Accepting new patients |
| Daniel Funsch Jr, M.D., P.C. | Single Specialty | Current |
Accepting new patients |
| Post Acute Specialists of Vermont PLC | Single Specialty | Current |
Accepting new patients |
| Mochi Medical Ca PC | Past | Accepting new patients | |
| Theoria Medical | Past | Accepting new patients | |
| Saint Francis Medical Center | Single Specialty | Past | Accepting new patients |
| Frederick Health Hospital Inc | Past | Accepting new patients |
Locations (25 of 41)
2710 Gateway Oaks Dr
Ste 150N
Sacramento, CA 95833
Phone (817) 966-0621
1660 Allison St
Lakewood, CO 80214
Phone (303) 232-7177
715 E King St
Seaford, DE 19973
Phone (302) 536-5628
5651 Limestone Rd
Wilmington, DE 19808
Phone (302) 239-8583
1290 Celebration Blvd
Kissimmee, FL 34747
Phone (321) 337-7400
633 NE 167th St
Ste 301
North Miami Beach, FL 33162
10095 Hillview Dr
Pensacola, FL 32514
Phone (850) 479-4000
1507 S Tuttle Ave
Sarasota, FL 34239
Phone (941) 366-0336
109 Forest Valley Dr
Forest Hill, MD 21050
Phone (410) 776-6038
347 Ballenger Center Dr
Frederick, MD 21703
Phone (301) 633-5181
1235 Potomac Valley Rd
Rockville, MD 20850
Phone (301) 299-2273
9200 Franklin Square Dr
Rosedale, MD 21237
Phone (410) 390-2600
200 Civic Ave
Salisbury, MD 21804
Phone (410) 749-1466
55378 Wilbur Rd
Three Rivers, MI 49093
Phone (269) 279-7441
515 Lake Concord Rd NE
Concord, NC 28025
Phone (704) 784-4494
228 Smith Chapel Rd
Mount Olive, NC 28365
Phone (919) 658-9522
25 Ridgewood Rd
Bedford, NH 03110
Phone (603) 222-0303
239 Pleasant St
Concord, NH 03301
Phone (603) 224-6561
20 Maitland St
Concord, NH 03301
Phone (516) 817-7093
677 Court St
Keene, NH 03431
Phone (603) 354-4157
175 Blueberry Ln
Laconia, NH 03246
Phone (603) 524-3340
103 Hospital Loop NE
Albuquerque, NM 87109
Phone (505) 348-8300
3594 E Tremont Ave
Ste 100
Bronx, NY 10465
Phone (718) 239-7176
885 3rd Ave
Fl 28
New York, NY 10022
Phone (929) 650-3990
100 9th St
McKeesport, PA 15132
Phone (412) 422-6800
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner |
363LF0000X | 5016648 | NC | Yes |
| Family Nurse Practitioner | 363LF0000X | 0024180193 | VA | |
| Family Nurse Practitioner | 363LF0000X | AC003520 | MD |
Addresses
Primary practice location
11618 Clayton Blvd
Clayton, NC 27520-2275
Mailing address
11618 Clayton Blvd
Clayton, NC 27520-2275
Phone (919) 416-8010
Other providers in Clayton, NC
- Always Family First Autism Services LLC.
- Always There Home Care & Consulting, LLC
- American Vets Mobility & Equipment Corp.
- Mercy Obioma Anagbogu
- Benjamin R Anderson
- Animal Assisted Therapy of the Triangle
- Anuvu Consulting Group
- Christina Arackal
- Ashay Counseling Agency
- Tsion Assefa
All providers in Clayton, NC · Family Nurse Practitioner in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 3, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.