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Individual provider Active NPI

Tara Naomi Nicolette, DO

  • Infectious Disease Physician
  • Spartanburg, SC
National Provider Identifier
1942568795
Registry record updated Jan 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
22008 Issued in NH
Practice address
101 E Wood St
Spartanburg, SC 29303-3040
Phone
(864) 560-6806
Fax
(864) 560-7329
NPI assigned
Apr 30, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2026

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 36193 SC
Infectious Disease Physician 207RI0200X 95410 GA
Infectious Disease Physician 207RI0200X 22008 NH Primary
Internal Medicine Physician 207R00000X 0116023970 VA
Infectious Disease Physician 207RI0200X 02005888A IN
Infectious Disease Physician 207RI0200X DO2022-0140 NM

Addresses

Primary practice location

101 E Wood St
Spartanburg, SC 29303-3040

Mailing address

PO Box 743070
Atlanta, GA 30374-3070
Phone (864) 560-4304

Other practice location 1

460 Northside Cherokee Blvd Ste 300
Canton, GA 30115-8019
Phone (770) 721-9630

Other practice location 2

1 Medical Center Dr
Lebanon, NH 03756-0001
Phone (603) 650-5000

Other identifiers 3

IdentifierTypeStateIssuer
SCM1003365OtherSCMEDICARE PIN
361932MedicaidSC
15322065000171MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, NM, NH, GA4 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20200618001369 WA Practitioner - Infectious Disease 9032410469 Reassigns benefits to 1 organization
I20231208002753 NM Practitioner - Internal Medicine 9032410469 Reassigns benefits to 1 organization
I20241018000138 NH Practitioner - Infectious Disease 9032410469 Reassigns benefits to 2 organizations
I20260206002054 GA Practitioner - Infectious Disease 9032410469 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dartmouth-Hitchcock ClinicGroup PAC ID 4183537509, 1,445 clinicians

Practice addresses (Care Compare)

1 Medical Ctr Dr
Lebanon, NH 03756-1000
Phone (603) 650-5000

Hospital & facility affiliations

  • Mary Hitchcock Memorial Hospital Hospital, Lebanon, NH, CCN 300003
  • New London Hospital Hospital, New London, NH, CCN 301304
  • Northside Hospital Cherokee Hospital, Canton, GA, CCN 110008
  • Alice Peck Day Memorial Hospital Hospital, Lebanon, NH, CCN 301305

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
00000GAMDOptometrist
0116023970VAMDInternal Medicine Physician
95410GAMDInfectious Disease Physician
22008NHMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince Jun 8, 2020 Accepting new patients
Medical Associates Professional Services, LLC Internal Medicine CurrentSince Feb 16, 2026 Accepting new patients
Dartmouth-Hitchcock Clinic Internal Medicine CurrentSince Oct 14, 2024 Accepting new patients
Deaconess Clinic Inc CurrentSince Jan 2, 2023 Accepting new patients
Unm Medical Group Inc CurrentSince Nov 1, 2023 Accepting new patients
Deaconess Clinic, Inc Infectious Disease CurrentSince Jan 2, 2023 Accepting new patients
Multicare Health System CurrentSince Jun 8, 2020 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Oct 14, 2024 Accepting new patients
Multicare Health System Current Accepting new patients
Unm Medical Group, Inc. CurrentSince Nov 1, 2023 Accepting new patients
Mary Hitchcock Memorial Hospital Internal Medicine CurrentSince Oct 14, 2024 Accepting new patients
Dartmouth-Hitchcock Clinic CurrentSince Oct 14, 2024 Accepting new patients
Deaconess Clinic Inc. Internal Medicine Current Accepting new patients
North Atlanta Professional Services LLC CurrentSince Feb 2, 2026 Accepting new patients
Northside Primary Care Professional Services,LLC Past Accepting new patients

Locations

450 Northside Cherokee Blvd
Canton, GA 30115
Phone (770) 224-1000

460 Northside Cherokee Blvd
Ste 300
Canton, GA 30115
Phone (770) 721-9630

1400 Northside Forsyth Dr
Ste 250
Cumming, GA 30041
Phone (770) 889-7118

520 Mary St
Ste 230
Evansville, IN 47710
Phone (812) 450-8600

421 Chestnut St
Evansville, IN 47713
Phone (812) 426-6645

1204 Williams St
Oakland City, IN 47660
Phone (812) 749-6187

1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922

933 Bradbury Dr SE
Ste 2222
Albuquerque, NM 87106
Phone (505) 272-1476

2211 Lomas Blvd NE
Unm, NM 87106
Phone (505) 272-1111

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

311 S L St
Tacoma, WA 98405
Phone (253) 403-1444

Interoperability endpoints

  • Direct secure messaging: tnicolette385174@reidhealth.direct-ci.com
  • Direct secure messaging: tnicolette385174@ecommunitydirect.com

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 11

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": "1335744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768867200000",
    "number": "1942568795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743070",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743070",
            "telephone_number": "864-560-4304",
            "fax_number": "864-560-4413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E WOOD ST",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293033040",
            "telephone_number": "864-560-6806",
            "fax_number": "864-560-7329"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "460 Northside Cherokee Blvd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "GA",
            "postal_code": "301158019",
            "country_code": "US",
            "telephone_number": "770-721-9630",
            "fax_number": "770-721-9631",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "NH",
            "postal_code": "037560001",
            "country_code": "US",
            "telephone_number": "603-650-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICOLETTE",
        "first_name": "TARA",
        "middle_name": "NAOMI",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-30",
        "last_updated": "2026-01-20",
        "certification_date": "2026-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "SC",
            "license": "36193",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "GA",
            "license": "95410",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NH",
            "license": "22008",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0116023970",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "IN",
            "license": "02005888A",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NM",
            "license": "DO2022-0140",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "SCM1003365",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "361932",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "15322065000171",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spartanburg, SC

Sources for this page

Verify at the official NPI Registry.