DR. TARA JEAN ROSE PSYD
NPI 1417670670
Psychologist in Charlotte, NC

Active since September 22, 2022PECOS EnrolledAccepts Medicare Assignment
1001 BLYTHE BLVD STE 4200, CHARLOTTE, NC 28203(704) 355-0101 Get Directions Write a Review

NPPES record last updated: November 13, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Nov 13, 2025, Sep 30, 2022, Sep 22, 2022 (3 updates tracked since 2022).

About Dr. Tara Jean Rose Psyd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. TARA JEAN ROSE PSYD (NPI 1417670670) is an individual psychologist in Charlotte, North Carolina, licensed in North Carolina (6935) and active in the NPI registry since September 2022. She is enrolled in Medicare PECOS, maintains a secondary practice location in Columbia, and is a graduate of Other (2021).

NPPES Registry Identity

NPI1417670670
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameDR. TARA JEAN ROSECredential: PSYD
Location Address1001 BLYTHE BLVD STE 4200Charlotte, NC 28203-5866
Mailing Address1001 Blythe Blvd Ste 4200Charlotte, NC 28203-5866
Sole ProprietorNo
Medical School CMSOtherGraduated 2021
Enumeration DateSeptember 22, 2022
Last NPPES UpdateNovember 13, 20253 updates tracked since enumeration
NPPES CertifiedNovember 13, 2025
✔ NPI 1417670670 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
Licenses✔ Licensed in NC · 6935✔ Licensed in SC · 1752
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
Also ListedPsychologist · ClinicalTaxonomy 103TC0700X · License PSY1752 (SC)
1001 BLYTHE BLVD STE 4200, Charlotte, NC 28203

Other Names 1

Former Name (1)Dr. Tara Jean Hoverstad Psyd

Secondary Practice Location 1

Location 17 Richland Medical Park Dr Ste 215Columbia, SC 29203-6863 · Phone (803) 434-3533 · Fax (803) 434-3904

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Tara Jean Rose Psyd is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7113393265
PECOS Enrollment IDI20251222000069
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

3

Medicare enrollment records show Tara Rose reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Pediatric Hematology-Oncology
1001 BLYTHE BLVD, STE 601A
Charlotte, NC 28203
  • Reassigned Medicare billing, North Carolina enrollment
  • 2,223 clinicians in this Medicare group
Gastroenterology
1025 MOREHEAD MEDICAL DR, STE 300
Charlotte, NC 28204
  • Reassigned Medicare billing, North Carolina enrollment
  • 1,534 clinicians in this Medicare group
Hospice and Palliative Medicine
1021 MOREHEAD MEDICAL DR, SUITE 5100-A
Charlotte, NC 28204
  • Reassigned Medicare billing, North Carolina enrollment
  • 1,646 clinicians in this Medicare group

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tara Rose's NPI number?

The NPI number for Tara Rose is 1417670670. It was assigned to this individual provider in the NPPES registry on September 22, 2022. The provider is also known as Dr. Tara Jean Hoverstad Psyd.

Where is Tara Rose located?

Tara Rose practices at 1001 Blythe Blvd Ste 4200, Charlotte, NC 28203. The listed phone number is (704) 355-0101.

What is Tara Rose's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Tara Rose enrolled in Medicare?

Yes. Tara Rose is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Tara Rose's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Tara Rose reassigns Medicare benefits to 3 organizations: Carolinas Medical Center (Charlotte, NC), The Charlotte-Mecklenburg Hospital Authority (Charlotte, NC) and Carolinas Physicians Network, Inc. (Charlotte, NC). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Tara Rose's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Tara Rose accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of North Carolina, Ambetter of Tennessee and Blue Cross and Blue Shield of NC and 5 other insurers list Tara Rose as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Tara Rose was last updated on November 13, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.