Individual provider Active NPI

Tara Lavern Burnett, M.D.

  • Family Medicine Physician
  • Smithfield, NC
National Provider Identifier
1366486623
Registry record updated Sep 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
9800480 Issued in NC
Practice address
517 N Brightleaf Blvd
Smithfield, NC 27577-4407
Phone
(919) 989-5200
Fax
(833) 438-6949
NPI assigned
Jun 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 9800480 NC Primary

Addresses

Primary practice location

517 N Brightleaf Blvd
Smithfield, NC 27577-4407

Mailing address

517 N Brightleaf Blvd
Smithfield, NC 27577-4407
Phone (919) 989-5200

Other identifiers 1

IdentifierTypeStateIssuer
891161VMedicaidNC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tara.burnett.1@32647.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170113002357 NC Practitioner - Family Practice 0143502740 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1995
Medicare assignment
May accept Medicare assignment
Group practices
Johnston CountyGroup PAC ID 8224011861, 19 clinicians

Practice addresses (Care Compare)

517 N Bright Leaf Blvd
Smithfield, NC 27577-4407
Phone (919) 989-5200

517 N Brightleaf Blvd
Smithfield, NC 27577-4407

521 N Brightleaf Blvd
Smithfield, NC 27577-4407
Phone (919) 989-5500

Hospital & facility affiliations

  • Johnston Health Hospital, Smithfield, NC, CCN 340090

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
9800480NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Johnston County Public Health Department CurrentSince Oct 22, 2016 Accepting new patients
County of Johnston North Carolina CurrentSince Oct 22, 2016 Accepting new patients

Locations

517 N Brightleaf Blvd
Smithfield, NC 27577
Phone (919) 989-5200

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759104000000",
    "number": "1366486623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "517 N BRIGHTLEAF BLVD",
            "city": "SMITHFIELD",
            "state": "NC",
            "postal_code": "275774407",
            "telephone_number": "919-989-5200",
            "fax_number": "833-438-6949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "517 N BRIGHTLEAF BLVD",
            "city": "SMITHFIELD",
            "state": "NC",
            "postal_code": "275774407",
            "telephone_number": "919-989-5200",
            "fax_number": "833-438-6949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURNETT",
        "first_name": "TARA",
        "middle_name": "LAVERN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-16",
        "last_updated": "2025-09-29",
        "certification_date": "2025-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "9800480",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891161V",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tara.burnett.1@32647.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "517 N Brightleaf Blvd",
            "city": "Smithfield",
            "state": "NC",
            "country_code": "US",
            "postal_code": "275774407",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Smithfield, NC

Sources for this page

Verify at the official NPI Registry.