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LORI ANNE TACKMAN MD
NPI 1497752968
Pediatrics in Supply, NC

Active since June 30, 2005PECOS Enrolled
20 MEDICAL CAMPUS DR NW STE 205, SUPPLY, NC 28462(910) 721-4400(910) 721-4409 Get Directions Write a Review

NPPES record last updated: October 26, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Oct 26, 2020, Aug 13, 2019 (2 updates tracked since 2019).

About Lori Anne Tackman Md NPPES

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

LORI ANNE TACKMAN MD (NPI 1497752968) is an individual pediatrics provider in Supply, North Carolina, licensed in North Carolina (2000-00146) and active in the NPI registry since June 2005. She is enrolled in Medicare PECOS and maintains a secondary practice location in Cary.

NPPES Registry Identity

NPI1497752968
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameLORI ANNE TACKMANCredential: MD
Location Address20 MEDICAL CAMPUS DR NW STE 205Supply, NC 28462
Mailing AddressPo Box 60447Charlotte, NC 28260-0447
Phone(910) 721-4400
Fax(910) 721-4409
Sole ProprietorNo
Enumeration DateJune 30, 2005
Last NPPES UpdateOctober 26, 20202 updates tracked since enumeration
NPPES CertifiedSeptember 6, 2020
✔ NPI 1497752968 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in NC · 2000-00146
Definition
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.
20 MEDICAL CAMPUS DR NW STE 205, Supply, NC 28462
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Secondary Practice Location 1

Location 197 Cornerstone DrCary, NC 27519-8403 · Phone (919) 460-0993 · Fax (919) 481-3952

Other Identifiers 2

Other126WXNC · Bcbs
Medicaid89126WXNC

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of North Carolina and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Lori Anne Tackman Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Reassignment

Medicare enrollment records show Lori Tackman reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Novant Health Medical Group, LLC
Same address
Orthopaedic Surgery
20 MEDICAL CAMPUS DR NW STE 104
Supply, NC 28462
  • Reassigned Medicare billing, North Carolina enrollment
  • 2,998 clinicians in this Medicare group
NPI 1336978063 (910) 575-5800

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28462 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$83.90 typical visit price
range $54.12 – $165.09
Typical copayment $20.97 (range $13.53 – $41.27)
Most-billed visit code 99203
Established Patient
$95.94 typical visit price
range $17.21 – $134.61
Typical copayment $23.98 (range $4.30 – $33.65)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NOVANT HEALTH MEDICAL GROUP, LLC
Pediatrics
20 MEDICAL CAMPUS DR NW STE 205
SUPPLY, NC 28462
Brunswick County (704) 384-0517
NICOLE EMILY NYBERG N.P.
Nurse Practitioner
20 MEDICAL CAMPUS DR NW STE 205
SUPPLY, NC 28462
Brunswick County (910) 721-4400
DR. BRIAN JAMES MCKLINDON DNP, FNP-C
Student in an Organized Health Care Education/Training Program
20 MEDICAL CAMPUS DR NW STE 205
SUPPLY, NC 28462
Brunswick County (910) 721-4400

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 Lori Tackman's NPI number?

The NPI number for Lori Tackman is 1497752968. It was assigned to this individual provider in the NPPES registry on June 30, 2005.

Where is Lori Tackman located?

Lori Tackman practices at 20 Medical Campus Dr NW Ste 205, Supply, NC 28462. The listed phone number is (910) 721-4400.

What is Lori Tackman's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Lori Tackman enrolled in Medicare?

Yes. Lori Tackman is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Lori Tackman's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Lori Tackman reassigns Medicare benefits to Novant Health Medical Group, LLC (Supply, NC). The 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 Lori Tackman's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Lori Tackman 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 1 other insurer list Lori Tackman 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 Lori Tackman was last updated on October 26, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years 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.