Active NPI
David E. Tart, MD
- Dermatology Physician
- Greensboro, NC
National Provider Identifier
1962405647
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 19409
- Practice address
- 5704 Hidden Orchard Dr
Greensboro, NC 27410-2523 - Phone
- (336) 404-3213
- NPI assigned
- May 24, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 19409 | NC | Primary |
Addresses
Primary practice location
5704 Hidden Orchard Dr
Greensboro, NC 27410-2523
Mailing address
5704 Hidden Orchard Dr
Greensboro, NC 27410-2523
Phone (336) 404-3213
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8981614 | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19409 | NC | MD | Dermatology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Skin Surgery Center PA | Past | Accepting new patients |
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.
-
- MOHS-Micrographic Surgery Physician
- Mount Pleasant, SC
- NPI 1851810279
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1116892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1441670400000",
"number": "1962405647",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5704 HIDDEN ORCHARD DR",
"city": "GREENSBORO",
"state": "NC",
"postal_code": "274102523",
"telephone_number": "336-404-3213"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5704 HIDDEN ORCHARD DR",
"city": "GREENSBORO",
"state": "NC",
"postal_code": "274102523",
"telephone_number": "336-404-3213"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TART",
"first_name": "DAVID",
"middle_name": "E.",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-05-24",
"last_updated": "2015-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "NC",
"license": "19409",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8981614",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Greensboro, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.