Active NPI
Hal Tanner
- Student in an Organized Health Care Education/Training Program
- Greenwood, SC
National Provider Identifier
1013759547
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- LL92495
- Practice address
- 155 Academy Ave
Greenwood, SC 29646-3869 - Phone
- (864) 725-4865
- NPI assigned
- Jun 6, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | LL92495 | SC | Primary |
Addresses
Primary practice location
155 Academy Ave
Greenwood, SC 29646-3869
Mailing address
155 Academy Ave
Greenwood, SC 29646-3869
Phone (864) 725-4865
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240729003104 | SC | Order and Referring Only - Family Practice | 3173069945 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LL92495 | SC | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1717632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1778630400000",
"number": "1013759547",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "155 ACADEMY AVE",
"city": "GREENWOOD",
"state": "SC",
"postal_code": "296463869",
"telephone_number": "864-725-4865"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "155 ACADEMY AVE",
"city": "GREENWOOD",
"state": "SC",
"postal_code": "296463869",
"telephone_number": "864-725-4865"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TANNER",
"first_name": "HAL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-06-06",
"last_updated": "2026-05-13",
"certification_date": "2026-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "SC",
"license": "LL92495",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greenwood, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.