Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1497752968 Individual Practitioner Female Practitioner

Dr. Lori Anne Tackman , MD

Pediatrics • Supply, NC

Professional Overview & Biography Verified Profile Summary

Dr. Lori Tackman, MD is a registered healthcare professional specializing in Pediatrics in Supply, NC. Practice services are available at 20 MEDICAL CAMPUS DR NW STE 205 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

20 Medical Campus Dr Nw Ste 205

Supply, NC 28462

Telephone 9107214400
Fax 9107214409
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in Supply, NC

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 22.6 Yrs
Regional Practice Density
2 Specialists

Practicing in Supply, NC (2422 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2020-09-06
Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License NC 2000-00146

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
89126WX (NC)
Commercial Insurance / Payer ID Bcbs
126WX (NC)

Secondary Practice Locations

97 Cornerstone Dr

Cary, NC 275198403

Phone: 9194600993

97 Cornerstone Dr

Cary, NC 275198403

Phone: 9194600993

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners
Nicole Nyberg , NP

Nurse Practitioner

NPI 1841615770

Nurse Practitioner

Dr. Brian Mcklindon , DNP, FNP-C

Student in an Organized Health Care Education/Training Program

NPI 1922994151

Doctor of Nursing Practice, Family Nurse Practitioner (Certified)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events
📍
Updated Practice Location August 13, 2019

Registered at 20 MEDICAL CAMPUS DR NW STE 205, SUPPLY, NC 28462 (Tel: 9107214400)

📍
Updated Business Mailing Address August 13, 2019

Registered at PO BOX 60447, CHARLOTTE, NC 282600447

NPI Profile Active July 31, 2013

NPI status registered as active in NPPES database

📍
Updated Practice Location July 31, 2013

Registered at 97 CORNERSTONE DR, CARY, NC 275198403 (Tel: 9194600993)

📍
Updated Business Mailing Address July 31, 2013

Registered at 97 CORNERSTONE DR, CARY, NC 275198403 (Tel: 9194600993)

👤
Provider Name / Credentials Updated July 31, 2013

Recorded as LORI TACKMAN, MD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 31, 2013

Pediatrics (License #2000-00146 in NC)

🟢
Initial NPI Registration & Enumeration June 30, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1497752968
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 30, 2005
Last Update: October 26, 2020
Sole Proprietor: No

Mailing Address

Po Box 60447

Charlotte, NC 282600447

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.