Mrs Tara Coburn, SOCIAL WORKER is a medicare enrolled "Social Worker - Clinical" provider in Dillon, South Carolina. Her current practice location is
207 E Monroe St, Dillon, South Carolina. You can reach out to her office (for appointments etc.) via phone at
(843) 774-4337.
Mrs Tara Coburn is licensed to practice in South Carolina (license number 10671) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1023407368.
Healthcare Provider's Profile
Full Name | Mrs Tara Coburn |
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Gender | Female |
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Speciality | Social Worker - Clinical |
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Location | 207 E Monroe St, Dillon, South Carolina |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1023407368
- Provider Enumeration Date: 01/09/2015
- Last Update Date: 09/13/2017
Medicare PECOS Information:
- PECOS PAC ID: 6406172485
- Enrollment ID: I20150310001942
Medical Identifiers
Medical identifiers for Mrs Tara Coburn such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1023407368 | NPI | - | NPPES |
LW1028 | Medicaid | SC | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
1041C0700X | Social Worker - Clinical | 10671 (South Carolina) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mrs Tara Coburn allows following entities to bill medicare on her behalf.
Entity Name | Caresouth Carolina Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1720082571 PECOS PAC ID: 1052221314 Enrollment ID: O20040511000280 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Tara Coburn is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Mrs Tara Coburn, SOCIAL WORKER 712 N Main St, Nichols, SC 29581-7237 Ph: (843) 845-2074 | Mrs Tara Coburn, SOCIAL WORKER 207 E Monroe St, Dillon, SC 29536-2557 Ph: (843) 774-4337 |
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