Active NPI
Tasha Wdowiak
- Licensed Practical Nurse
- Granite Falls, NC
National Provider Identifier
1558205070
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 71354
- Practice address
- 249 River Bend Dr
Granite Falls, NC 28630-9388 - Phone
- (855) 508-1993
- NPI assigned
- Apr 15, 2026
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 71354 | NC | Primary |
Addresses
Primary practice location
249 River Bend Dr
Granite Falls, NC 28630-9388
Mailing address
249 River Bend Dr
Granite Falls, NC 28630-9388
Phone (855) 508-1993
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71354 | NC | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1776211200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1776211200000",
"number": "1558205070",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "249 RIVER BEND DR",
"city": "GRANITE FALLS",
"state": "NC",
"postal_code": "286309388",
"telephone_number": "855-508-1993"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "249 RIVER BEND DR",
"city": "GRANITE FALLS",
"state": "NC",
"postal_code": "286309388",
"telephone_number": "855-508-1993"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WDOWIAK",
"first_name": "TASHA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-04-15",
"last_updated": "2026-04-15",
"certification_date": "2026-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "NC",
"license": "71354",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Granite Falls, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.