Active NPI
Mattlyn Lauren Tart, PHARMD, CPP
- Ambulatory Care Pharmacist
- Clayton, NC
National Provider Identifier
1336897594
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Care Pharmacist
- License
- 700353
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 29740 | NC | MD | Pharmacist |
| 700353 | NC | MD | Ambulatory 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.