Tara Reisha Edwards-Booker, D.O

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

2018-02021 Issued in NC

Practice address

13425 Hoover Creek Blvd Ste 100
Charlotte, NC 28273

Phone

(704) 316-2080

NPI assigned

Apr 23, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Internal Medicine

Education

Ohio University, College of Osteopathic Medicine, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Proactive Therapy of North Carolina IncGroup PAC ID 6305753120, shared by 5 NPIs, 540 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Novant Health Matthews Medical Center Hospital, Matthews, NC, CCN 340171
• Novant Health Presbyterian Medical Center Hospital, Charlotte, NC, CCN 340053
• Novant Health Ballantyne Medical Center Hospital, Charlotte, NC, CCN 340195

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tedwardsbooker669309@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.

• Novant Health Medical Group, LLC

  • Neurology with Special Qualifications in Child Neurology Physician
  • Charlotte, NC
  • NPI 1366409492

  NC

  Medicare reassignment Care Compare group NPD
• Novant Health Medical Group, LLC

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

  • Family Medicine Physician
  • Charlotte, NC
  • NPI 1548406978
  NPD
• Novant Health Medical Group, LLC

  • Internal Medicine Physician
  • Charlotte, NC
  • NPI 1134841802

  Internal Medicine

  NPD (past)
• Doctors Community Practices LLC

  • Internal Medicine Physician
  • Lanham, MD
  • NPI 1932567401

  Internal Medicine

  NPD (past)

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

• Novant Health Ballantyne Medical Center LLC

  • General Acute Care Hospital
  • Charlotte, NC
  • NPI 1740998020

  Hospital

  Care Compare affiliation
• Novant Health Matthews Medical Center LLC

  • General Acute Care Hospital
  • Matthews, NC
  • NPI 1063463156

  Hospital

  Care Compare affiliation
• The Presbyterian Hospital

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Charlotte, NC
  • NPI 1396798591

  Hospital

  Care Compare affiliation
• The Presbyterian Hospital

  • Psychiatric Hospital Unit
  • Charlotte, NC
  • NPI 1497708838

  Hospital

  Care Compare affiliation
• The Presbyterian Hospital

  • General Acute Care Hospital
  • Charlotte, NC
  • NPI 1881647204

  Hospital

  Care Compare affiliation
• The Presbyterian Hospital

  • Skilled Nursing Facility
  • Charlotte, NC
  • NPI 1891871901

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1335139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603670400000",
    "number": "1932467370",
    "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",
            "telephone_number": "844-266-8268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13425 HOOVER CREEK BLVD STE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28273",
            "telephone_number": "704-316-2080"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6502 Kenilworth Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Riverdale",
            "state": "MD",
            "postal_code": "207371372",
            "country_code": "US",
            "telephone_number": "301-927-0088",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 Upper Chesapeake Dr",
            "address_2": "Upper Chesapeake Medical Services, Inc",
            "address_purpose": "LOCATION",
            "city": "Bel Air",
            "state": "MD",
            "postal_code": "210144324",
            "country_code": "US",
            "telephone_number": "443-643-1500",
            "fax_number": "443-643-1505",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDWARDS-BOOKER",
        "first_name": "TARA",
        "middle_name": "REISHA",
        "name_prefix": "Dr.",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-23",
        "last_updated": "2020-10-26",
        "certification_date": "2020-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "H79827",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2018-02021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tedwardsbooker669309@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "500 Upper Chesapeake Dr",
            "address_2": "Upper Chesapeake Medical Services, Inc",
            "city": "Bel Air",
            "state": "MD",
            "country_code": "US",
            "postal_code": "210144324",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Educare Community Living Corporation - North Carolina
• Educare Community Living Corporation-North Carolina
• Educare Communtiy Living Corporation - North Carolina
• Education Service for Early Intervention
• Subhash Venkata Satya Edupuganti, MD
• Andrew Paul Edwards, CRNA
• Anna Edwards, PT, DPT
• Ashley Leann Edwards, CRNA
• Carmen Edwards
• Cathy Lewis Edwards

• Internal Medicine Physician in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Internal Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2020; 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.
• Medicare Care Compare (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.