Individual provider Active NPI

Brantley Austin Tart, PNP-PC

  • Pediatric Nurse Practitioner
  • Wilmington, NC
National Provider Identifier
1093467599
Registry record updated Nov 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
5015665 Issued in NC
Practice address
715 Medical Center Dr
Wilmington, NC 28401-7574
Phone
(910) 763-2476
NPI assigned
Jan 25, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 5015665 NC Primary

Addresses

Primary practice location

715 Medical Center Dr
Wilmington, NC 28401-7574

Mailing address

715 Medical Center Dr
Wilmington, NC 28401-7574
Phone (910) 763-2476

Other practice location 1

16747 US Highway 17 Ste 114
Hampstead, NC 28443-3086
Phone (910) 763-2476

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
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5015665NCMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Pediatrics CurrentSince Feb 1, 2022 Accepting new patients
Carolina Pediatrics Pediatrics PastSince Feb 1, 2022 Accepting new patients

Locations

16747 US Highway 17
Ste 114
Hampstead, NC 28443
Phone (910) 270-0052

16747 US Highway 17
Hampstead, NC 28443
Phone (252) 944-3725

715 Medical Center Dr
Wilmington, NC 28401
Phone (910) 763-2476

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/4693/brand/6/csg/1/fhir/r4

Organizations & group practices 2

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": "1643068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763596800000",
    "number": "1093467599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 MEDICAL CENTER DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017574",
            "telephone_number": "910-763-2476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 MEDICAL CENTER DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017574",
            "telephone_number": "910-763-2476"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16747 US Highway 17 Ste 114",
            "address_purpose": "LOCATION",
            "city": "Hampstead",
            "state": "NC",
            "postal_code": "284433086",
            "country_code": "US",
            "telephone_number": "910-763-2476",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TART",
        "first_name": "BRANTLEY",
        "middle_name": "AUSTIN",
        "name_prefix": "Mr.",
        "credential": "PNP-PC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-25",
        "last_updated": "2025-11-20",
        "certification_date": "2025-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NC",
            "license": "5015665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2025; 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.