Tara Anne Craig – Family Medicine Physician

Key facts

NPI: 1679130892
Entity type: Individual (NPI type 1)
Primary specialty: Family Medicine Physician 207Q00000X
License: 2022-01968 (NC)
Practice address: 75 Emerson Bay Rd Ste 102
Carolina Shores, NC 28467-2498
Phone: (910) 579-8363
Fax: (910) 579-8306
NPI assigned: May 22, 2019
Sex: Female
Sole proprietor: No

Organizations & group practices 1

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.

Novant Health Medical Group, LLC Neurology with Special Qualifications in Child Neurology Physician · Charlotte, NC · NPI 1366409492

NPD

Hospital & facility affiliations 2

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

Brunswick Community Hospital, LLC General Acute Care Hospital · Bolivia, NC · NPI 1710915756

Care Compare affiliation Hospital
McLeod Loris Seacoast Hospital General Acute Care Hospital · Loris, SC · NPI 1306123344

Care Compare affiliation Hospital

Medicare Care Compare profile

Specialty: Family Practice
Education: Other, 2019
Medicare assignment: Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3545 Whitehall Park Dr
Suite 300
Charlotte, NC 28273-4179

PO Box
Charlotte, NC 28260

Hospital & facility affiliations

Novant Health Brunswick Medical Center Hospital · Supply, NC · CCN 340158
McLeod Loris Hospital Hospital · Loris, SC · CCN 420105

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file
Eligible to order & refer: Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Doctor of Medicine

Practice roles

Organization	Specialty	Status	New patients
Novant Health Medical Group, LLC		Current	Accepting new patients

Interoperability endpoints

Direct secure messaging: tbonilla1067487@direct.novanthealth.org

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Family Medicine Physician	207Q00000X	2022-01968	NC	Yes

Addresses

Primary practice location

75 Emerson Bay Rd Ste 102
Carolina Shores, NC 28467-2498

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other practice location 1

4070 Highway 17
Murrells Inlet, SC 29576-5033
Phone (843) 652-1293

Electronic endpoints

Type	Endpoint	Use	Affiliation
Direct Messaging Address	tbonilla1067487@direct.novanthealth.org

Other providers in Carolina Shores, NC

All providers in Carolina Shores, NC · Family Medicine Physician in North Carolina

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 16, 2023. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Order and Referring (CMS).
Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.