Individual provider Active NPI

Tara Baran, OTR

  • Occupational Therapist
  • Supply, NC
National Provider Identifier
1295334498
Registry record updated Feb 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
13630 Issued in NC
Practice address
58 Physicians Dr NW Ste 106
Supply, NC 28462-4216
Phone
(910) 755-6075
Fax
(910) 406-4111
NPI assigned
Oct 20, 2020
Last updated
Feb 9, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 13630 NC Primary

Addresses

Primary practice location

58 Physicians Dr NW Ste 106
Supply, NC 28462-4216

Mailing address

58 Physicians Dr NW Ste 106
Supply, NC 28462-4216
Phone (910) 755-6075

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221025002023 NC Practitioner - Occupational Therapist in Private Practice 7315313897 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Coastline Therapy Group, LLC Occupational Therapist CurrentSince Jul 13, 2022 Accepting new patients
Creative Hands Occupational Therapy Past Accepting new patients
J.Z. Mann Pediatric Therapy, Inc. PastSince Oct 25, 2020 Accepting new patients
Coastal Speech and Reading Center Past Accepting new patients

Locations

3901 Wrightsville Ave
Ste 120
Wilmington, NC 28403

4130 Oleander Dr
Ste 101
Wilmington, NC 28403

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1603152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770595200000",
    "number": "1295334498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58 PHYSICIANS DR NW STE 106",
            "city": "SUPPLY",
            "state": "NC",
            "postal_code": "284624216",
            "telephone_number": "910-755-6075",
            "fax_number": "910-406-4111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58 PHYSICIANS DR NW STE 106",
            "city": "SUPPLY",
            "state": "NC",
            "postal_code": "284624216",
            "telephone_number": "910-755-6075",
            "fax_number": "910-406-4111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARAN",
        "first_name": "TARA",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-20",
        "last_updated": "2026-02-09",
        "certification_date": "2026-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "13630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Supply, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.