Individual provider Active NPI

Tara M Staton, MD

  • Family Medicine Physician
  • Goldsboro, NC
National Provider Identifier
1649253360
Registry record updated Feb 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
000001902 Issued in NC
Practice address
2609 Medical Office PL
Goldsboro, NC 27534-9428
Phone
(919) 734-1779
NPI assigned
Nov 28, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2011

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 000001902 NC Primary

Addresses

Primary practice location

2609 Medical Office PL
Goldsboro, NC 27534-9428

Mailing address

2609 Medical Office PL
Goldsboro, NC 27534-9428
Phone (919) 734-1779

Other identifiers 5

IdentifierTypeStateIssuer
89134VYMedicaidNC
P00314273OtherNCRAILROAD MEDICARE
188452OtherNCMEDCOST
134VYOtherNCBCBS NC
8565117OtherNCCIGNA HEALTHCARE

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
I20050803000420 NC Practitioner - Family Practice 4981632676 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Duke University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vidant Medical Group LLCGroup PAC ID 0345343893, 986 clinicians

Practice addresses (Care Compare)

105 Hospital Dr
Tarboro, NC 27886-2011
Phone (252) 641-7714

111 Hospital Dr
Tarboro, NC 27886-2011
Phone (252) 641-8585

212 Smith Church Rd
Roanoke Rapids, NC 27870-4914
Phone (252) 537-1717

220 Smith Church Rd
Roanoke Rapids, NC 27870-4914
Phone (252) 537-9268

250 Smith Church Rd
Roanoke Rapids, NC 27870-4914
Phone (252) 535-8240

401 A N Main St
Kenansville, NC 28349-8801
Phone (910) 296-0941

401 N Main St
Kenansville, NC 28349-8801
Phone (910) 296-0941

417 N Main St
Kenansville, NC 28349-8801
Phone (910) 296-8080

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.95 of 100Reported as apm
Quality
82.44
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
000001902NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Roanoke Valley Health Services Inc Family Medicine Current Accepting new patients
Vidant Medical Group LLC CurrentSince Jun 8, 2021 Accepting new patients
Sound Physicians of North Carolina, PLLC Family Medicine CurrentSince Jan 1, 2022 Accepting new patients

Locations

1144 N Road St
Elizabeth Cty, NC 27909
Phone (252) 384-4610

2700 Wayne Memorial Dr
Goldsboro, NC 27534
Phone (919) 731-6060

2310 Stantonsburg Rd
Greenville, NC 27834
Phone (252) 847-6611

600 Moye Blvd
Greenville, NC 27834
Phone (252) 744-1111

401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941

2000 Neuse Blvd
New Bern, NC 28560
Phone (252) 633-8104

210 Smith Church Rd
Ste B
Roanoke Rapids, NC 27870
Phone (252) 535-8870

1385 Medical Center Dr
Roanoke Rapids, NC 27870
Phone (252) 537-9176

250 Smith Church Rd
Roanoke Rapids, NC 27870
Phone (252) 308-9699

111 Hospital Dr
Tarboro, NC 27886
Phone (252) 641-7700

Organizations & group practices 5

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 4

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": "1133136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296518400000",
    "number": "1649253360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2609 MEDICAL OFFICE PL",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275349428",
            "telephone_number": "919-734-1779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2609 MEDICAL OFFICE PL",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275349428",
            "telephone_number": "919-734-1779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STATON",
        "first_name": "TARA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-28",
        "last_updated": "2011-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "000001902",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89134VY",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00314273",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "188452",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NC",
            "identifier": "134VY",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTHCARE",
            "identifier": "8565117",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Goldsboro, NC

Sources for this page

Verify at the official NPI Registry.