Individual provider Active NPI

Tanner William Stalun, PA-C

  • Physician Assistant
  • Huntersville, NC
National Provider Identifier
1457197444
Registry record updated Jul 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
16455 Statesville Rd Ste 420
Huntersville, NC 28078-7140
Phone
(704) 892-2949
NPI assigned
Jul 8, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

16455 Statesville Rd Ste 420
Huntersville, NC 28078-7140

Mailing address

10328 Remembrance TRL
Huntersville, NC 28078-5913

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241217004512 NC Practitioner - Physician Assistant 7315474103 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Urology Specialists of the Carolinas PLLCGroup PAC ID 0648178020, 78 clinicians
Proactive Therapy of North Carolina IncGroup PAC ID 6305753120, shared by 5 NPIs, 540 clinicians

Practice addresses (Care Compare)

16455 Statesville Rd
Suite 420
Huntersville, NC 28078-7140
Phone (704) 892-2949

201 McCullough Dr
Suite 310
Charlotte, NC 28262-3577
Phone (704) 547-1129

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Urology Specialists of the Carolinas CurrentSince Jul 21, 2024 Accepting new patients

Locations

16455 Statesville Rd
Ste 420
Huntersville, NC 28078
Phone (704) 355-7874

Interoperability endpoints

  • Direct secure messaging: tstalun@urologyspecialistsnc.emadirect.md
  • Direct secure messaging: tstalun1207589@carolinashealthcaresystem.direct-ci.com

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 6

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": "1720396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720396800000",
    "number": "1457197444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10328 REMEMBRANCE TRL",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280785913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16455 STATESVILLE RD STE 420",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280787140",
            "telephone_number": "704-892-2949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STALUN",
        "first_name": "TANNER",
        "middle_name": "WILLIAM",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-08",
        "last_updated": "2024-07-08",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntersville, NC

Sources for this page

Verify at the official NPI Registry.