Lori Anne Tackman, MD
Lori Anne Tackman is a Pediatrics Physician provider (Pediatrics) practicing in Supply, NC, registered in the NPPES registry with NPI 1497752968 since 2005. The credential MD stands for Doctor of Medicine. Practices at Novant Health Medical Group, LLC (listed at the same practice address in NPPES).
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1497752968 |
|---|---|
| Entity type | Individual (Type 1) |
| Name | Lori Anne Tackman |
| Credential | MD |
| Sex | Female |
| Practice address | 20 MEDICAL CAMPUS DR NW STE 205, Supply, NC, 28462 |
| Phone | 9107214400 |
| Fax | 9107214409 |
| Enumeration date | 2005-06-30 |
| Last updated in NPPES | 2020-10-26 |
Taxonomy & licenses
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 208000000X | Pediatrics Physician | Primary | 2000-00146 | NC |
MD — Doctor of Medicine: A physician who completed medical school (allopathic medicine), residency training, and state licensure. About the MD credential
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 126WX | Other | NC | BCBS |
| 89126WX | Medicaid | NC | — |
Copy-ready billing details
Provider: Lori Tackman, MD NPI: 1497752968 Taxonomy: 208000000X (Pediatrics Physician) Address: 20 MEDICAL CAMPUS DR NW STE 205, Supply, NC, 28462
Other providers at this practice address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1841615770 | Nicole Nyberg | Individual | Nurse Practitioner | Supply, NC |
| 1235798992 | Novant Health Medical Group, LLC | Organization | Pediatrics Physician | Supply, NC |
| 1922994151 | Brian Mcklindon | Individual | Student in an Organized Health Care Education/Training Program | Supply, NC |
Verify this record
Cross-check NPI 1497752968 against the authoritative CMS record: view Lori Anne Tackman on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
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Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2020-10-26.