Individual Healthcare Provider
Lori Anne Tackman, MD
Provider's NPPES record last updated: October 26, 2020
Overview
- Entity Type
- Individual Healthcare Provider
- NPI
- 1497752968
- Primary Specialty
- Pediatrics
- Practice Location
- Supply, North Carolina
- Sole Proprietor
- No
Federal Screening
NPISignal checked this NPI against federal exclusion sources. Results below are based on the NPI number itself — an identifier match, not a name match.
List of Excluded Individuals/Entities (LEIE)
HHS Office of Inspector General
No potential match was identified in NPISignal's indexed List of Excluded Individuals/Entities (LEIE) records as of 2026-09-10.
- Source data
- September 10, 2026
- Records indexed
- 84,001
- Screened
- Sep 19, 2026, 12:28 PM UTC
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
SAM.gov Exclusions
U.S. General Services Administration
SAM.gov Exclusions was not checked.
SAM.gov screening is not configured on this deployment. No SAM check has been performed.
- Screened
- Not checked
This is an NPI-based check only. NPISignal does not publish name-based exclusion matches on a provider profile. A shared or similar name is a lead that requires human review, not an identification, and this page is not the place to make one. Run a name-based screening below to see potential matches with the reasons for each.
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
Searches OIG LEIE and SAM.gov by name and reviews every potential match.
Specialties & Taxonomies
- Primary
Pediatrics
Allopathic & Osteopathic Physicians
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.
Taxonomy code 208000000X
Provider-Reported License Information
- Pediatrics (North Carolina)
- 2000-00146
Practice Locations
Practice Location
20 Medical Campus Dr Nw Ste 205
Supply, North Carolina 28462
Phone: (910) 721-4400
Additional Practice Location
97 Cornerstone Dr
Cary, North Carolina 27519-8403
Phone: (919) 460-0993
Fax: (919) 481-3952
Additional Practice Location
97 Cornerstone Dr
Cary, North Carolina 27519-8403
Phone: (919) 460-0993
Fax: (919) 481-3952
Record Information
- Enumeration Date
- June 30, 2005
- Provider's NPPES Record Last Updated
- October 26, 2020
- Certification Date
- September 6, 2020
- NPISignal NPPES Dataset
- August 2026
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