NICHOLAS TANNENBAUM NPI 1013584382

NPI Information

  • NPI: 1013584382
  • Provider Name: NICHOLAS TANNENBAUM
  • Classification: Emergency Medicine - 207PE0004X
  • Specialization: Emergency Medical Services
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 2817 ROCK MERRITT AVE
    FORT BRAGG, NC
    ZIP 28310
  • Phone: (910) 907-8922

Map and Directions

Get Directions

NPI Details

Nicholas Tannenbaum is an emergency medical services emergency medicine in Fort Bragg, NC. The provider is an emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. Nicholas Tannenbaum NPI is 1013584382. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2817 ROCK MERRITT AVE
FORT BRAGG, NC
ZIP 28310-004
Phone: (910) 907-8922
Fax: (910) 907-6069

The NPI 1013584382 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/7/2021 and was last updated on 7/16/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207PE0004XEmergency MedicineEmergency Medical Services12918GEORGIANo
2207PE0004XEmergency MedicineEmergency Medical Services2024-01464NORTH CAROLINAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI
Next NPI