Individual provider Active NPI

Mattlyn Lauren Tart, PHARMD, CPP

  • Ambulatory Care Pharmacist
  • Clayton, NC
National Provider Identifier
1336897594
Registry record updated Mar 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Care PharmacistTaxonomy code 1835P2201X
License
700353 Issued in NC
Practice address
2076 NC Highway 42 W Ste 100
Clayton, NC 27520-5303
Phone
(919) 359-0322
NPI assigned
Mar 16, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 29740 NC
Ambulatory Care Pharmacist 1835P2201X 700353 NC Primary

Addresses

Primary practice location

2076 NC Highway 42 W Ste 100
Clayton, NC 27520-5303

Mailing address

4420 Lake Boone TRL
Raleigh, NC 27607-7505
Phone (919) 784-3100

Other practice location 1

910 Berkshire Rd
Smithfield, NC 27577-4751
Phone (919) 989-7909

Other practice location 2

6602 Knightdale Blvd Ste 205
Knightdale, NC 27545-6526
Phone (395) 598-4215

Other practice location 3

2800 Blue Ridge Rd Ste 400
Raleigh, NC 27607-6477
Phone (919) 787-5380

Other practice location 4

110 Pine State St
Lillington, NC 27546-9414
Phone (910) 814-3201

Other practice location 5

4414 Lake Boone Trl Ste 505
Raleigh, NC 27607-7521
Phone (919) 784-2300

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
29740NCMDPharmacist
700353NCMDAmbulatory Care Pharmacist

NPI Registry JSON

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

{
    "created_epoch": "1647388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647388800000",
    "number": "1336897594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4420 LAKE BOONE TRL",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276077505",
            "telephone_number": "919-784-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2076 NC HIGHWAY 42 W STE 100",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275205303",
            "telephone_number": "919-359-0322"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "910 Berkshire Rd",
            "address_purpose": "LOCATION",
            "city": "Smithfield",
            "state": "NC",
            "postal_code": "275774751",
            "country_code": "US",
            "telephone_number": "919-989-7909",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6602 Knightdale Blvd Ste 205",
            "address_purpose": "LOCATION",
            "city": "Knightdale",
            "state": "NC",
            "postal_code": "275456526",
            "country_code": "US",
            "telephone_number": "395-598-4215",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2800 Blue Ridge Rd Ste 400",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276076477",
            "country_code": "US",
            "telephone_number": "919-787-5380",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "110 Pine State St",
            "address_purpose": "LOCATION",
            "city": "Lillington",
            "state": "NC",
            "postal_code": "275469414",
            "country_code": "US",
            "telephone_number": "910-814-3201",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4414 Lake Boone Trl Ste 505",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276077521",
            "country_code": "US",
            "telephone_number": "919-784-2300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TART",
        "first_name": "MATTLYN",
        "middle_name": "LAUREN",
        "name_prefix": "Dr.",
        "credential": "PHARMD, CPP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-16",
        "last_updated": "2022-03-16",
        "certification_date": "2022-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "29740",
            "primary": false
        },
        {
            "code": "1835P2201X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Ambulatory Care",
            "state": "NC",
            "license": "700353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clayton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2022; 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.