Tara Goodlett Gaines, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

200200525 Issued in NC

Practice address

311 Coddle Market Dr NW
Ste 100
Concord, NC 28027

Phone

(980) 302-9100

NPI assigned

Jan 26, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 7

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tgaines549731@direct.novanthealth.org

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.

• NH Digital Health Services, LLC

  • Family Medicine Physician
  • Winston Salem, NC
  • NPI 1427683044
  Medicare reassignment NPD
• Novant Health Medical Group, LLC

  • Neurology with Special Qualifications in Child Neurology Physician
  • Charlotte, NC
  • NPI 1366409492
  Medicare reassignment NPD
• NH Digital Health Services, LLC

  • Hematology & Oncology Physician
  • Winston Salem, NC
  • NPI 1386506855
  NPD
• Novant Health Medical Group, LLC

  • Pediatrics Physician
  • Huntersville, NC
  • NPI 1215454053
  NPD
• Novant Health Medical Group, LLC

  • Obstetrics & Gynecology Physician
  • Matthews, NC
  • NPI 1386506137
  NPD
• Novant Health Medical Group, LLC

  • Internal Medicine Physician
  • Charlotte, NC
  • NPI 1134841802
  NPD (past)
• Uwharrie Regional Pediatrics, PA

  • Pediatrics Physician
  • Albemarle, NC
  • NPI 1033130117
  NPD (past)

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686787200000",
    "number": "1801866355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 CODDLE MARKET DR NW",
            "address_2": "STE 100",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "28027",
            "telephone_number": "980-302-9100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1420 US Highway 52 N",
            "address_2": "Suite A",
            "address_purpose": "LOCATION",
            "city": "Albemarle",
            "state": "NC",
            "postal_code": "280012622",
            "country_code": "US",
            "telephone_number": "704-982-5437",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10305 Hamptons Park Dr Ste 101",
            "address_purpose": "LOCATION",
            "city": "Huntersville",
            "state": "NC",
            "postal_code": "280787221",
            "country_code": "US",
            "telephone_number": "704-384-1130",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAINES",
        "first_name": "TARA",
        "middle_name": "GOODLETT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-26",
        "last_updated": "2023-06-15",
        "certification_date": "2023-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "200200525",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8913114",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "13114",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1200893",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2943796",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARTNERS MCR CHOICE",
            "identifier": "800286",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "280247",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "B6712",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tgaines549731@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "1420 US Highway 52 N",
            "address_2": "Suite A",
            "city": "Albemarle",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280012622",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Giuliana Guerci Gage, M.D.
• Jessica Barbara Gagnon, PA-C
• Desiree Gaines, PHARMD
• Greinlei Gaines
• Jenna Gaines
• Judith Kraus Gais, FNP
• Kerry Ann Gallagher, CRNA
• Kimberly Smith Gallagher, FNP
• Robert J Galup, DDS
• Jeffrey Michael Galvin, M.D.

• Pediatrics Physician in Concord, NC
• Providers in Concord, NC by specialty
• Pediatrics Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.