Tanner Paul Brondhaver, DO
Individual provider Active NPI Family Medicine Physician · Morehead, KY
NPI 1013597608 · NPPES record last updated Jun 14, 2024
Key facts
- NPI
- 1013597608
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- R5677 (KY)
- Practice address
- 222 Medical Cir
Morehead, KY 40351-1179 - Phone
- (606) 783-6455
- Fax
- (606) 784-2767
- NPI assigned
- Apr 9, 2021
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 20
Hospital & facility affiliations 8
Owned or controlled facilities with NPI records 1
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Lincoln Mem Univ, Debusk Col of Osteopathic Med, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- St. Claire Medical Center Inc
Practice addresses (Care Compare)
316 W 2ND St
Morehead, KY 40351-1550
Phone (606) 784-3771
Hospital & facility affiliations
- St Claire Medical Center Home Health
- Hospice of the Bluegrass, Inc.
- St Claire Regional Medical Center
- King'S Daughters' Medical Center
- Morgan County Arh Hospital
- West Liberty Nursing and Rehabilitation
Merit-based Incentive Payment System (MIPS)
- Final score
- 73.64 of 100
- Quality
- 56.63
- Improvement activities
- 40
- Cost
- 74.98
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 1-10 |
| Removal of skin lesions | 1-10 |
| Skin biopsy | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
All facility ownership & control disclosures 1
| Facility | Type | Role | Since |
|---|---|---|---|
| West Liberty Nursing and Rehabilitation LLC |
Skilled nursing facility | Operational/Managerial Control Adp of the SNF |
Jan 1, 2025 Jan 1, 2025 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240815003320 | KY | Practitioner - Family Practice | 0345623880 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
Practice roles (9 of 10)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Claire Medical Center, Inc | Family Medicine | Current | Accepting new patients |
| St Claire Medical Center, Inc., | Family Medicine | Current | Accepting new patients |
| St. Claire Medical Center,Inc | Current | Accepting new patients | |
| St Claire Medical Center, Inc | Current |
Accepting new patients | |
| St. Claire Medical Center, Inc | Current | Accepting new patients | |
| St. Claire Medical Center,Inc | Current | Accepting new patients | |
| St. Claire Medical Center, Inc | Current |
Accepting new patients | |
| West Liberty Nursing and Rehabilitation LLC | Past | Accepting new patients | |
| Sprocket Medical Management LLC | Past | Accepting new patients |
Locations
732 Highway 36
Frenchburg, KY 40322
Phone (606) 768-2191
316 W 2nd St
Morehead, KY 40351
Phone (606) 783-6400
245 Flemingsburg Rd
Morehead, KY 40351
Phone (606) 780-5500
222 Medical Cir
Morehead, KY 40351
Phone (606) 783-6455
632 Slate Ave
Owingsville, KY 40360
Phone (606) 674-6386
390 S Ky 7
Sandy Hook, KY 41171
Phone (606) 738-5155
774 Liberty Rd
West Liberty, KY 41472
Phone (606) 473-3846
Networks
- KY PPO
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | R5677 | KY | Yes |
Addresses
Primary practice location
222 Medical Cir
Morehead, KY 40351-1179
Mailing address
222 Medical Cir
Morehead, KY 40351-1179
Phone (606) 783-6455
Other providers in Morehead, KY
- Brent L. McDaniel DDS PSC
- Elizabeth Brewer
- Brightfuturenow
- Evan Brizzell
- Jonas Brobeck
- Lindsey Brooks
- Haley Jade Bruss
- Jordan Bryant
- Laura Buckner
- Adam Bunting
All providers in Morehead, KY · Family Medicine Physician in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 14, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.