Individual provider Active NPI

Tania Diaz, ARNP, PPCNP-BC

  • Pediatric Nurse Practitioner
  • Clayton, NC
National Provider Identifier
1801380704
Registry record updated Jun 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
5015622 Issued in NC
Practice address
104 Medspring Dr
Clayton, NC 27520-9687
Phone
(919) 235-6535
Fax
(919) 231-0314
NPI assigned
Jun 14, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 5015622 NC Primary

Addresses

Primary practice location

104 Medspring Dr
Clayton, NC 27520-9687

Mailing address

PO Box 603949
Charlotte, NC 28260-3949
Phone (877) 498-4490

Other practice location 1

1519 E Booker Dairy Rd
Smithfield, NC 27577-9472
Phone (919) 823-5437 ext. 4

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
I20250402002225 NC Practitioner - Nurse Practitioner 1658894449 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wakemed Specialists Group LLC CurrentSince Apr 14, 2025 Accepting new patients
Wakemed Specialists Group, LLC Current Accepting new patients
Wakemed Specialists Group, LLC CurrentSince Apr 14, 2025 Accepting new patients
Wake Med Children's PM Pediatric Urgent Care PastSince Aug 1, 2022 Accepting new patients

Locations

104 Medspring Dr
Clayton, NC 27520
Phone (919) 235-6422

3000 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-7000

Interoperability endpoints

  • Direct secure messaging: tdiaz107552@directhisp.wakemed.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1528934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750896000000",
    "number": "1801380704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 603949",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282603949",
            "telephone_number": "877-498-4490",
            "fax_number": "919-350-7687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 MEDSPRING DR",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275209687",
            "telephone_number": "919-235-6535",
            "fax_number": "919-231-0314"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1519 E Booker Dairy Rd",
            "address_purpose": "LOCATION",
            "city": "Smithfield",
            "state": "NC",
            "postal_code": "275779472",
            "country_code": "US",
            "telephone_number": "919-823-5437 x4",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIAZ",
        "first_name": "TANIA",
        "credential": "ARNP, PPCNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-14",
        "last_updated": "2025-06-26",
        "certification_date": "2025-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NC",
            "license": "5015622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clayton, NC

Sources for this page

Verify at the official NPI Registry.